慢性阻塞性肺疾病患者运动能力与通气效率的相关性分析  

The association between ventilatory efficiency and exercise tolerance in patients with chronic obstructire pulmonary disease

作　　者：袁玮[1] 王浩彦[1] 徐秋芬[1] 吴波[1] 赵旭娟[1] 李滨[1] 

机构地区：[1]首都医科大学附属北京友谊医院呼吸内科,北京100050

出　　处：《心肺血管病杂志》2013年第1期57-60,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:通过分析二氧化碳通气当量和运动能力的关系,探讨稳定期慢性阻塞性肺疾病(COPD)患者运动中通气效率与最大运动能力的相关性。方法:选取54例稳定期COPD患者,行运动心肺功能测试,实时监测摄氧量(VO2)、分钟通气量(VE)和二氧化碳排出量(VCO2),根据公式:EqCO2=VE/VCO2计算得出静态二氧化碳通气当量(EqCO2rest)、无氧阈时二氧化碳通气当量(EqCO2at)和最大运动状态下的二氧化碳通气当量(EqCO2max)。结果:1.EqCO2rest、EqCO2at及EqCO2max呈递减趋势,差异有统计学意义(P=0.001)。2.EqCO2at与最大摄氧量(VO2max)(r=-0.294,P<0.05)、EqCO2max与VO2max(r=-0.301,P<0.05)均呈负相关;EqCO2rest与最大摄氧量占预计值的百分比(VO2max/Pred)呈负相关(r=-0.345,P<0.05)。3.肺功能GOLD 3级患者(21例)的VO2max(15.99±3.39)mL·min-1·kg-1明显低于GOLD 2级患者(25例)的VO2max[(18.88±5.36)mL·min-1·kg-1,P=0.038]。两组的EqCO2rest、EqCO2at及EqCO2max差异无统计学意义。结论:稳定期COPD患者运动中通气效率呈进行性下降趋势,这可能是导致其运动能力下降的重要因素之一。Objective： To evaluate the association between ventilatory efficiency and exercise tolerance in patients with chronic obstructive pulmonary disease（COPD）.Methods：A total of 54 patients with stable mild to very severe COPD were enrolled in this study.The patients were reported lung function test,including forced vital capacity（FVC）,forced expiratory volume in one second（FEV1）,FEV1predicted（FEV1%）.All took cardiopulmonary exercise test（CPET）.Oxygen uptake（VO2）,carbon dioxide output（VCO2） and minute ventilation（VE） were measured continuously on the breath-by-breath mode.Ventilatory equivalent for carbon dioxide（EqCO2） was measured according to equation of VE/VCO2.Results：1.EqCO2 decreased as work rate increased during exercise.EqCO2 significantly decreased at anaerobic threshold（AT） and at maximal exercise compared with that at rest（P=0.000）.There was significant difference EqCO2 between at rest,AT and maximal exercise（P=0.000）.2.There was negative correlation between maximal oxygen uptake（VO2max） and EqCO2 at AT（r=-0.294,P0.05）and negative correlation between VO2max and EqCO2 at maximal exercise（r=-0.301,P0.05）.3.Peak oxygen uptake were significantly lower in GOLD level 3 group than in GOLD level 2 group ·min-1·kg-1,P=0.038].EqCO2 at rest,at AT and at maximal exercise were not statistically different between GOLD level 3 group and GOLD level 2 group.Conclusion：Lower level of EqCO2 during exercise could be associated with the decrease of maximal exercise tolerance in patients with COPD.

关 键 词：慢性阻塞性肺疾病 二氧化碳通气当量 最大运动能力 

分 类 号：R56[医药卫生—呼吸系统]