慢性阻塞性肺疾病患者呼吸肌力的研究

目的 研究慢性阻塞性肺疾病(COPD)患者呼吸肌力及中枢驱动性与常规肺功能的关系。方法 对66例COPD患者进行最大吸气压、最大呼气压及口腔阻断压、常规肺功能测定及动脉血气分析。结果 COPD组最大吸气压及最大呼气压明显低于健康组,中枢驱动性明显高于健康组。COPD患者FRC/TLC％、RV％pred、FRC％pred及FEV_1与最大吸气压及中枢驱动性显著相关,其中FRC/TLC％与最大吸气压相关性最好(r=-0.581 P<0.001)。FEV_1和FRC/TLC％与最大呼气压无相关。动脉血氧分压及二氧化碳分压与最大吸气压相关,与最大呼气压及中枢驱动性无相关性。TLC％pred与最大吸气压、最大呼气压及中枢驱动性均无相关性。结论 COPD患者存在呼吸肌功能障碍,肺过度膨胀和气道阻塞是影响COPD患者吸气肌力的重要因素。

A Study of Respiratory Muscle Strength in Patients With Chronic Obstructive Pulmonary Disease

Purpose In order to assess respiratory muscle strength and central inspiratory drive and their relationship to lung function tests in patients with chronic obstructive pulmonary disease (COPD). Methods We measured in 66 patients with chronic obstructive pulmonary disease the maximum inspiratory and expiratory pressure (Pimax, Pemax, cm H2O% pred) , Inspiratory pressure after 0.1 sec. at tidal breathing (P0.1) , lung function and arterial gas analysis respectively. Results COPD patients showed significantly lower Pimax and Pemax and higher P0.1 than normal subjects. The FRC/TLC% ,RV% pred,FRC% pred and FEV1 were significantly correlated with Pimax and P0.1. Among them, Pimax was the most closely correlated with FRC/TLC% ( r = - 0.581 P < 0.001). There were no relationship between FEV1, FRC/TLC% and Pemax. PaO2 and PaCO2 were only correlated with Pimax. No relationship between PaO2, PaCO2 and Pemax, P0.1.TLC% pred was not correlated with Pimax,Pemax and P0.1. Conclusions There is respiratory muscle strength dysfunction in COPD patients. Hyperinflation and airway obstruction predominantly affected inspiratory muscle strength in a group of COPD patients.