慢性阻塞性肺疾病患者深吸气量与运动能力的关系  

Relationship between inspiratory capacity and exercise endurance in COPD patients

作　　者：陈瑞[1] 陈荣昌 陈新[3] 

机构地区：[1]中山大学孙逸仙纪念医院呼吸内科,广东广州510120 [2]广州医学院呼吸疾病国家重点实验室,广东广州510120 [3]南方医科大学珠江医院呼吸内科,广东广州510282

出　　处：《中国病理生理杂志》2011年第5期972-975,共4页Chinese Journal of Pathophysiology

基　　金：广东省科技计划社会发展项目(No.E002009062);广东省自然科学基金研究团队项目(No.04205342)

摘　　要：目的:探讨慢性阻塞性肺疾病(COPD)患者深吸气量与运动能力的关系。方法:采用呼气负压技术(NEP)检测42例缓解期COPD患者平静呼吸时呼气气流受限(EFL)情况。将COPD患者分为EFL组和无EFL组,并进行常规肺功能和症状限制递增功率心肺运动测试。结果:42例COPD患者中29例在平静呼吸时检测到EFL,13例未检测到EFL。与无EFL组相比,EFL组深吸气量占预计值百分比(IC%pred)(P<0.01)、第1 s用力呼气容积占预计值百分比(FEV1%pred)(P<0.01)、第1 s用力呼气容积占用力肺活量百分比(FEV1/FVC%)(P<0.01)、比弥散量占预计值百分比(DLCO/VA%pred)(P<0.05)和最大摄氧量占预计值百分比(VO2m ax%pred)(P<0.01)均显著下降。多元逐步回归分析结果表明,IC%pred和FEV1%pred对VO2m ax%pred有显著预测意义。在EFL组,IC%pred与VO2m ax%pred的相关性最好(r=0.787,P<0.01);在无EFL组,FEV1%pred与VO2m ax%pred的相关性最好(r=0.625,P<0.01)。结论:在平静呼吸时出现EFL的COPD患者,肺过度充气可能是运动能力下降的主要原因;在平静呼吸时无EFL的COPD患者,气流阻塞可能是运动能力下降的主要原因。AIM： To explore the relationship between inspiratory capacity（IC） and exercise endurance in chronic obstructive pulmonary diseases（COPD） patients.METHODS： Forty-two COPD patients were enrolled in the study.The technique of negative expiratory pressure（NEP） was employed to assess expiratory flow limitation（EFL） of the COPD patients at rest.Simultaneously,routine pulmonary function tests and an incremental symptom-limited exercise test were performed.RESULTS： Twenty-nine patients had EFL and 13 patients were non-EFL at rest.Compared with non-EFL group,IC%pred（P0.01）,FEV1%pred（P0.01）,FEV1/FVC%（P0.01）,DLCO/VA%pred（P0.05） and VO2max%pred（P0.01） in EFL group were significantly decreased.The results of stepwise regression analysis indicated that IC%pred and FEV1%pred were the only significant contributors to exercise tolerance.Subgroup analysis showed that IC%pred was correlated best with VO2max%pred in EFL patients（r=0.787,P0.01）,and FEV1%pred was correlated best with VO2max%pred in non-EFL patients（r=0.625,P0.01）.CONCLUSION： In COPD patients with EFL at rest,hyperinflation may be the main reason for the reduction of exercise tolerance,otherwise in non-EFL patients,airway obstruction probably plays a key role in limiting exercise endurance.

关 键 词：肺疾病 慢性阻塞性 吸气量 呼气流速受限 

分 类 号：R563[医药卫生—呼吸系统]