中重度慢性阻塞性肺疾病患者动态肺过度充气与运动能力的关系

【目的】探讨慢性阻塞性肺疾病(COPD)患者动态肺过度充气与运动能力的关系。【方法】对26例稳定期中重度COPD患者和12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踏车心肺运动测试。在静息状态和运动过程中每隔1 min记录受试者潮式呼吸时流速容积曲线和深吸气量(IC)。【结果】COPD组在症状限制递增功率运动高峰时,IC(L)较静息状态下降(1.55±0.46 vs 2.17±0.50,P<0.001);运动高峰时ΔIC与摄氧量呈负相关(r=-0.422,P<0.05);运动高峰时IC与静息状态时IC呈负相关(r=-0.743,P<0.001),与运动高峰时潮气量(VT)呈负相关(r=-0.755,P<0.001)。【结论】动态肺过度充气可能是COPD患者在症状限制递增功率运动中运动能力下降的主要原因之一。

Correlation between Dynamic Hyperinflation and Exercise Capacity in Patients with Maderate to Severe Chronic Obstructive Pulmonary Disease

【Objectives】 To study the correlation between dynamic hyperinflation(DH) and exercise capacity in patients with chronic obstructive pulmonary disease(COPD).【Methods】 Routine lung ventilation function,diffusing function,lung volume and an incremental symptom-limited cycle ergometer exercise were tested in 26 stable COPD patients and 12 healthy controls.Flow-volume curve during tidal breathing and inspiratory capacity(IC) were detected every 1 min at rest and exercise.【Results】 The IC(L) was significantly lower in COPD patients at peak exercise than at rest(1.55 ± 0.46 vs 2.17 ± 0.50,P < 0.001).The ΔIC was negatively correlated with the peak oxygen consumption in COPD patients(r =-0.422,P < 0.05).The peak IC was negatively correlated with both resting IC(r =-0.743,P < 0.001) and peak VT(r =-0.755,P < 0.001) in COPD patients.【Conclusions】 DH might be one of the important factors for exercise intolerance in stable COPD patients during incremental symptom-limited cycle exercise.