踏车锻炼对慢性阻塞性肺疾病患者吸气肺功能的影响及与运动能力改善的关系  

Effect of treadmill training on inspiratory function and its association with improvement of exercise capacity in patients with chronic obstructive pulmonary disease

作　　者：陈瑞[1] 陈功[2] 毛晓群[1] 陈新[3] 

机构地区：[1]中山大学附属二院呼吸内科,广州510120 [2]泸州医学院附属医院放射科 [3]南方医科大学珠江医院呼吸内科

出　　处：《中华老年医学杂志》2011年第8期621-625,共5页Chinese Journal of Geriatrics

基　　金：基金项目：广东省科技计划社会发展项目（E002009062）

摘　　要：目的探讨踏车锻炼对慢性阻塞性肺疾病（COPD）患者吸气肺功能的影响及与运动能力改善的关系。方法对12例中、重度COPD患者进行12周的下肢踏车运动训练。在运动训练前后分别进行常规肺通气功能、弥散功能、肺容积、最大用力吸气峰流速（PIF）、最大吸气压（MIP）、症状限制递增功率心肺运动试验和高强度恒定功率心肺运动试验。在高强度恒定功率运动中，每隔1min记录受试者潮式呼吸流速-容积（TBFV）曲线。结果踏车锻炼后COPD患者运动持续时间（T）（t=7．357，P〈0．001）和峰运动功率（WRpeak）（t=3．614，P〈0．05）显著增加；MIP（t=4．754，P〈0．001）和PIF（t=2．440，P〈0．05）显著增加；踏车锻炼后COPD患者在等时间点潮式呼吸吸气峰流速（t=-2．747，P〈0．05）和呼气峰流速（t=-4．487，P〈0．05）均较前显著下降，最大吸气流速储备较前显著增加（t=2．755，P〈0．05），最大呼气流速储备较前无显著变化（t=1．326，P〉0．05）。受试者下肢踏车锻炼后MIP的增加（r=0．613，P〈0．05）、PIF的增加（r=0．497，P〈0．05）和等时间点最大吸气流速储备的增加（r=0．592，P〈0．05）分别与运动持续时间的增加呈显著正相关。结论下肢运动训练可改善COPD患者吸气肺功能指标；运动训练后吸气肌肉力量、PIF和运动中吸气流速储备的增加可能是COPD患者运动能力改善的主要原因。Objective To explore the effect of treadmill training on inspiratory function and its association with improvement of exercise capacity in patients with chronic obstructive pulmonary disease （COPD）. Methods The 12 moderate to severe COPD patients were allocated to lower-limb exercise training for 12weeks. The routine tests of pulmonary ventilation function, diffusion function, lung volume, peak inspiratory flow （PIF）, maximal inspiratory pressure （ MIP）, symptom-limited progressive cycle ergometer exercise tests and constant work rate exercise tests were administered before and after the training program. During the constant work rate exercise tests, tidal breathing flow volume （TBFV） curves were recorded every 1 rain. Results After treadmill training, the exercise duration （T） （t=7. 357, P〈0. 001）, peak work rate （WRpeak） （t=3. 614, P〈0.05）, MIP （t=4.754, P〈0.001） and PIF （t=2.440, P〈0.05） increased significantly. The tidal PIF （t=-2. 747, P〈0.05） and peak expiratory flow （PEF） （t=-4. 487, P〈0.05） decreased significantly at isotime. Maxium inspiratory flow reserve （AFLOWinsp） （t = 2. 755, P 〈 0.05 ） increased significantly at isotime, and maxium expiratory flow reserve （AFLOWexp） （t=1. 326, P〉0.05） showed no significant changes; The AT were positively correlated with △MIP （r=0. 613, P〈0.05）, APIF （r= 0. 497, P〈0.05） and △FLOWinsp （r= 0. 592, P〈0.05）. Conclusions Lower limb exercise training improves inspiratory function of COPD patients. The improvement of exercise endurance in moderate to severe COPD patients after lower limb exercise training is due to increases of inspiratory muscle strength, maxium PIF and inspiratory flow reserve.

关 键 词：肺疾病 慢性阻塞性 肺康复 运动训练 呼吸困难 

分 类 号：R563.9[医药卫生—呼吸系统]