吸入异丙托溴胺对慢性阻塞性肺疾病患者运动肺功能的影响

目的 评价吸入异丙托溴胺(ipratropium bromide,IPB)是否改善慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的静态肺功能,运动通气功能和运动耐量.方法 随机抽取稳定期COPD患者12例,吸入IPB溶液2 mg,吸人前后分别进行静态肺功能和运动肺功能测定.结果 吸入IPB后,COPD患者最大运动功率(Wmax)、最大耗氧量(VO2max)、最大运动时每分钟通气量(Vemax)和比潮气量(Vtmax/IC),较吸人前均有显著增加;死腔通气(VD/VT)和二氧化碳通气当量(Vemax/VCO2max)无明显改变.Vtmax/IC的变化(⊿Vtmax/IC)与VO2max的变化(⊿VO2max)有显著相关性(r=0.598,P＜0.05);⊿Vtmax/IC与最大运动功率的变化(⊿Wmax)也存在显著相关性(r=0.743,P＜0.05).结论 吸入IPB能够增加COPD患者的运动耐量,COPD患者吸入IPB后,⊿Vtmax/IC可能是运动耐量增加机制中的一个重要环节.

Effect of inhaling ipratropium bromide to patients with chronic obstructive pulmonary disease on ventilation and exercise capacity during exercise

Objective To evaluate the effect of inhaling ipratropium bromide(IPB)to patients with chronic obstructive pulmonary disease(COPD)on ventilation and exercise capacity during exercise.Methods All 12 stable patients were diagnosed as COPD.Before and after inhaling single-dose IPB,symptom-limited progressive cycle ergometer exercise tests were performed.Results The maximal rate of work,maximal oxygen uptake,the maximal volume of ventilation per minute and the maximal ratio of tidal volume to inspiratory capacity increased significantly after inhaling IPB solution of four times the standard dose.The maximal dead space/tidal volume ratio and the maximal ventilatory equivalent for CO2 had no change.There was a significant correlation between the amount of the maximal ratio of tidal volume to inspiratory capacity improved and amount of maximal oxygen uptake improved(r=0.598,P＜0.05).Another significant correlation exited between the amount of maximal rate of work improved and amount of the maximal ratio of tidal volume to inspiratory capacity improved(r=0.743,P＜0.05).Conclusions Inhaling single-dose IPB will be helpful in improving exercise tolerance of patients.The improvement of maximal ratio of tidal volume to inspiratory capacity could be an important factor about inhaling IPB how to improve exercise tolerance of patients.