慢性阻塞性肺疾病患者劳力性呼吸困难与动态肺过度充气的关系  

Correlation between exertional dyspnea and dynamic hyperinflation in patients with chronic obstructive pulmonary diseases

作　　者：陈瑞[1] 陈功[2] 陈荣昌 陈新[4] 

机构地区：[1]中山大学孙逸仙纪念医院呼吸内科,广州510120 [2]泸州医学院附属医院放射科,四川泸州646000 [3]广州医学院呼吸疾病国家重点实验室,广州510120 [4]南方医科大学珠江医院呼吸内科,广州510280

出　　处：《第三军医大学学报》2011年第18期1977-1979,共3页Journal of Third Military Medical University

基　　金：广东省科技计划社会发展项目(E002009062);广东省自然科学基金团队项目(04205342)~~

摘　　要：目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)患者在高强度恒定功率运动中呼吸困难的产生与动态肺过度充气的关系。方法对34例稳定期COPD患者和10例健康人进行常规肺通气功能、弥散功能、肺容量和症状限制递增功率心肺运动测试。以症状限制递增功率心肺运动测试获得的最大运动功率的2/3作为运动功率进行高强度恒定功率运动试验,在静息状态和运动过程中每隔1分钟记录受试者Borg呼吸困难评分、潮式呼吸-流速容积(TBFV)曲线和深吸气量(inspiratory capacity,IC)。结果 COPD组在高强度恒定功率运动高峰时,IC[(1.56±0.29)L]较静息状态[(2.07±0.38)L]显著下降(t=-5.642,P<0.01),ΔBorg与ΔIC呈显著负相关关系(r=-0.59,P<0.01)。在运动高峰时COPD组平均呼气流速和呼气时间显著低于对照组。结论动态肺过度充气可能是COPD患者在高强度恒定功率运动中呼吸困难产生的主要原因之一;平均呼气流速下降和呼气时间缩短可能是COPD患者动态肺过度充气产生的原因。Objective To study the correlation between exertional dyspnea and dynamic hyperinflation in patients with chronic obstructive pulmonary diseases（COPD）.Methods Routine lung ventilation function,diffusing function,lung volume and symptom-limited progressive cycle ergometer exercise were tested in 34 stable COPD patients and 10 healthy controls.Two-thirds of their symptom-limited peak work rate was used to conduct high-intensity CWRE test.Borg dyspnea score,TBFV curve and inspiratory capability（IC） were detected every 1 min at rest and exercise.Results The IC was significantly lower in COPD patients at peak exercise than at rest（1.56±0.29 L vs 2.07±0.38 L,t=-5.642,P0.01）.The ΔBorg was negatively correlated with the ΔIC in COPD patients（r=-0.59,P0.01）.The mean expiratory flow and time were significantly lower in COPD patients than in healthy controls at peak exercise time（P0.05）.Conclusion Dynamic hyperinflation is one of the important factors for dyspnea in stable COPD patients during high-intensity CWRE exercise.The decreased mean expiratory flow and time may be the reason for dynamic hyperinflation in COPD patients during exercise.

关 键 词：肺疾病 慢性阻塞性 呼吸困难 动态肺过度充气 

分 类 号：R563.902[医药卫生—呼吸系统] R441.8[医药卫生—内科学]