论文部分内容阅读
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 investigate the relationship between dyspnea and dynamic over-inflation in patients with chronic obstructive pulmonary disease (COPD) under high-intensity and constant-power exercise. Methods Thirty-four patients with stable COPD and 10 healthy subjects underwent routine pulmonary ventilation, diffusion function, and lung capacity and symptom limitation ascending power cardiopulmonary exercise test. Two-thirds of the maximum exercise power obtained with the symptom-limited progressive cardiopulmonary exercise test was used as the exercise power for the high-intensity constant-power exercise test, and the Borg dyspnoea score was recorded every 1 minute during rest and during exercise Style breath-flow volume (TBFV) curve and inspiratory capacity (IC). Results Compared with resting state [(2.07 ± 0.38) L], IC [(1.56 ± 0.29) L] significantly decreased at the peak of high intensity and constant power exercise in COPD group (t = -5.642, P <0.01) Significant negative correlation (r = -0.59, P <0.01). At the peak of exercise, the mean expiratory flow and expiratory time in COPD group were significantly lower than those in control group. Conclusions Dynamic lung hyperinflation may be one of the main causes of dyspnea in COPD patients during high-intensity and constant-power exercise. The decrease of average expiratory flow rate and shortened expiratory time may be responsible for the dynamic over-inflation of COPD patients.