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目的 探讨慢性阻塞性肺疾病(简称慢阻肺)患者的摄氧效率特点,并分析其对于慢阻肺患者运动耐力的影响.方法 选择2009年8月至2012年8月在上海市肺科医院呼吸科就诊的慢阻肺稳定期患者59例,其中男53例,女6例；年龄42 ～80岁,平均(62±9)岁；按照病情严重程度再分为Ⅰ级组15例、Ⅱ级组16例、Ⅲ级组19例、Ⅳ级组9例.同年龄段健康志愿者29名为对照组.对所有受试者进行常规肺功能检测及斜坡式功率递增症状限制性心肺运动试验,采用逐次呼吸法对呼吸交换参数进行收集和分析.计数资料用构成比表示,两组间比较采用t检验和x2检验,多组间比较采用单因素方差分析,相关分析采用Pearson相关性检验.结果 慢阻肺组摄氧效率斜率(OUES)和摄氧效率平台(OUEP)[(1.9 ±0.3) L· min-1·lg(L·min-1)-1和(31 ±5) ml/L]均显著低于对照组[(2.2±0.4) L·min-1 ·lg(L· min-1)-1和(35 ±4) ml/L],差异均有统计学意义(t值分别为4.57和3.39,均P＜0.01)；Ⅰ级组OUES、OUEP和无氧阈时的摄氧效率[(2.09±0.31)L·min-1·lg(L·min-1)-1、(34±5)和(34±5)ml/L]与对照组[(2.23 ±0.39)L·min-1·lg(L·min-1)-1、(35±4)和(34 ±4) ml/L]的差异无统计学意义(t值为0.36 ～ 1.49,均P＞0.05)；Ⅱ～Ⅳ级组OUES[(2.05 ±0.26)、(1.76±0.28)和(1.63 ±0.19)L·min-1·lg(L·min-1)-1-]均显著低于对照组[(2.23±0.39) L· min-1·lg(L· min-1)-1],差异均有统计学意义(t值为2.42～5.26,均P＜0.05)；Ⅱ～Ⅲ级组OUEP和无氧阈时的摄氧效率[(31±4)和(31±5)ml/L、(29 ±5)和(29 ±5) ml/L]均显著低于对照组[(35±4)和(34 ±4) ml/L],差异均有统计学意义(t值为2.18～4.83,均P＜0.05)；慢阻肺组OUES、OUEP和无氧阈时的摄氧效率与运动耐力(峰值摄氧量占预计值％)均呈正相关(r值为0.500 ～0.625,均P＜0.01).结论 慢阻肺患者的摄氧效率显著低于健康人,且与患者的运动耐力呈显著正相关.“,”Objective To explore the characteristics of oxygen uptake efficiency (OUE) in patients with chronic obstructive pulmonary disease (COPD),and to analyze the relationship between OUE and the exercise capacity.Methods Pulmonary function test and cardiopulmonary exercise test were performed in 59 patients with stable COPD (grade Ⅰ,n =15; grade Ⅱ,n =16; grade Ⅲ,n =19; grade Ⅳ,n =9) and 29 healthy volunteers of the same age.Their successive breathing respiratory exchange parameters were collected and analyzed.t test and x2 test were used for 2 sample comparison,while multiple comparisons among groups were performed by using single factor analysis of variance.Correlation analysis was done by Pearson correlation test.Results Compared with the normal control group [(2.2 ± 0.4) L · min-1 · lg(L · min-1)-1 ; (35 ± 4) ml/L],the OUES and OUEP of the COPD patient group [(1.9 ± 0.3) L ·min-1 · lg(L · min-1)-1 ; (31 ± 5) ml/L] were significantly lower (t =4.57,3.39,all P ＜ 0.01).The OUE of the grade Ⅰ patients showed no significant difference compared with the normal control group (t =0.36-1.49,all P ＞ 0.05),while the OUES of the grade Ⅱ-Ⅳ patients [(2.05 ± 0.26),(1.76 ±0.28) and (1.63 ±0.19) L · min-1 · lg(L · min-1)-1] decreased significantly compared to the normal control group [(2.23 ± 0.39) L · min-1 · lg(L · min-1)-1 ; t =2.42-5.26,all P ＜ 0.05].The OUEP and the OUE at the anaerobic threshold of the grade Ⅱ-Ⅲ patients [(31 ±4) and (31 ±5),(29 ±5)and (29 ±5) ml/L] decreased significantly compared to the normal control group [(35 ±4) and (34 ±4)ml/L,t =2.18-4.83,all P ＜ 0.05].The OUES,OUEP and the OUE at the anaerobic threshold in COPD patients were correlated (r =0.500-0.625,all P ＜ 0.01) positively with the exercise tolerance (peakVO2％ pred).Conclusions The oxygen uptake efficiency of patients with COPD is significantly reduced compared to that of the normal subjects,and is correlated positively with the exercise capacity.