脉冲振荡法测定COPD患者静息时呼吸阻抗与运动能力的关系  

The correlation of impedance measured with IOS and exercise capacity in COPD patients

作　　者：郭忠良[1] 蔡映云[1] 梁永杰[1] 揭志军[1] 杨文兰[1] 王美琴[1] 

机构地区：[1]上海医科大学附属中山医院肺科,200032

出　　处：《上海医学》1999年第11期663-666,共4页Shanghai Medical Journal

摘　　要：目的　探讨ＣＯＰＤ 患者静息时脉冲振荡法（ＩＯＳ） 测得呼吸阻抗指标与最大运动能力的关系。方法　３０ 例ＣＯＰＤ 患者先用ＩＯＳ法测定呼吸阻抗值（ 包括共振频率Ｆｒｅｓ、总阻抗Ｚ、中央阻抗Ｒｃｅｎｔｌ、周围阻抗Ｒｐｅｒｉ、电阻Ｒ５ 至Ｒ３５ 、电抗Ｘ５ 至Ｘ３５） 后进行自行车增量运动试验，记录最大运动负荷（ Ｗｍａｘ） 、最大氧耗量（Ｖｍａｘ） 、最大ＣＯ２ 排出量（ＶＣＯ２ｍａｘ） 、最大每分通气量（ＶＥｍａｘ）、最大潮气量（ＶＴｍａｘ） 、最大气急指数（ＤＩ）和最低血氧饱和度（ＳａＯ２ｍｉｎ） ，运动过程中进行脉氧、心率、血压和胸腹运动协同性监测。结果　极量运动时ＶＥｍａｘ 与Ｆｒｅｓ 最相关（ｒ ＝ － ０ ．６７） ，其次与Ｒ５ 和Ｒ２０ 差值（Ｒ５ － Ｒ２０） 、Ｘ１５ 、Ｘ２０ 、Ｘ２５ 和Ｘ３５ 显著相关，与Ｚ、Ｒ５ 、Ｒ１０ 、Ｘ５ 和Ｘ１０ 有一定的相关性；ＶＴｍａｘ 与Ｆｒｅｓ 最相关（ｒ＝ － ０ ．６２），其次与Ｘ１５ 、Ｘ２０ 和Ｘ２５ 显著相关，与Ｒ５ 和Ｒ１０ 有一定的相关；ＳａＯ２ｍｉｎ 主要与Ｆｒｅｓ、Ｒ５ 和Ｘ２０ 相关（ｒ 均为０ ．４３） ；极量运动时胸腹呼吸运动总和与潮气量的比值（ＴＣＤ／ＶＴ）与Ｒ１０Objective To evaluate the correlation between parameters of impedance measured with impulse oscillometry (IOS) and exercise capacity assessed by incremental exercise test. Methods thirty moderate to severe COPD patients were included. Impedance measurements were performed with IOS before cycle ergometer test, and parameters of impedance included the resonance frequency (Fres), the impedance of the respiratory system (Z), the resistance of central airways(Rcentl) and peripheral airways(Rperi), the resistance (R) and the reactance(X) calculated in the frequency range 5～35Hz. During exercise testing, oxygen saturation (SaO 2), heart rate (HR), blood pressure (BP), and thoracoabdominal motion (assessed by TCD/VT) were monitored. Minute ventilation (VE), tidal volume (VT), respiratory rate (RR), oxygen uptake (VO 2) and carbon dioxide output (VCO 2) were measured every 20s with a computerized system. Results VEmax was significatly correlated with Fres( γ =-0.67), R5-R20( γ =-0.48), X15( γ =0.54), X20( γ =0.58),X25( γ =0.58) and X35( γ = 0.48). VTmax had significant correlations with Fres( γ =-0.62), X15( γ =0.47), X20( γ =0.55) and X25( γ =0.55). A correlation was also found between VTmax and Z, R5,R10,X5, and X10. SaO 2min was just related to Fres, R5 and X20. TCD/VT was weakly related to R10. Wmax, VO2max, VO2max/kg, and VCO 2max were unrelated the some parameters of impedance measured with IOS. Conclusion The variations of ventilation reaction, blood oxygen saturation, and thoracoabdominal motion wene related to some parameters of impedance measured with IOS. but no relation was found between maximal exercise capacity and parameters of impedance(Shanghai Med J, 1999, 22:663 666).

关 键 词：慢性阻塞性肺病 脉冲振荡法 运动能力 

分 类 号：R563.9[医药卫生—呼吸系统]