慢性阻塞性肺疾病呼吸驱动影响因素分析

Influencing factor analysis of respiratory drive in patients with chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病(COPD)病人呼吸驱动与肺功能、血气及静息能量代谢之间的关系。方法:26例COPD和21例正常对照者分别测定口腔阻断压P0.1、呼吸肌功能[最大吸气压(PIMAX)、最大呼气压(PEMAX)]、肺通气功能[努力肺活量(FVC)、一秒率(FEV1%)]、残气(RV/TLC)、弥散功能(DLCO)、静息能量代谢(REE)、呼吸商(RQ)、血气分析及Borg分级等。结果:COPD组P0.1和P0.1/PIMAX高于对照组(P<0.01)。相关分析COPD组P0.1与PaO2、SaO2负相关(r分别为-0.62,-0.53,P均<0.05),而与PaCO2相关性不明显。Borg分级与P0.1正相关(r=0.63,P<0.05),P0.1与FVC、FEV1%、RV/TLC、DLCO以及RQ无相关性,P0.1/PIMAX与REE有正相关关系(r=0.41,P<0.05)。结论:COPD呼吸驱动增高,不仅与PaO2,SaO2相关,还与静息能量代谢及Borg分级等相关。

Objective： To study the relationship between the respiratory drive and pulmonary function and the relationship between the blood gas analysis and resting energy expenditure in patients with chronic obstructive pulmonary disease （COPD）. Methods： Twenty-six patients with COPD and 21 normal subjects were included in this study. The mouth occlusion pressure （P0.1）, the respiratory muscles function such as the max inspiratory pressure （PIMAX） and the max expiratory pressure （PEMAX）, the ventilatory function such as FVC% and FEV1%, RV/TLC, DLCO, resting energy expendi- ture （REE）, respiratory quotient （RQ）, blood gas analysis, and Borg scale were determined, respectively. Results： The P0.1 and P0. 1 / P IMAX in COPD patients were higher than those in the control subjects [ （3.31± 2.14） mmHg vs. （2.92 ± 1.27） mmHg, （0.068 ± 0. 026） vs. （0.039 ± 0. 014）, P 〈 0.01 ]. In COPD patients, P0.1, was negatively correlated with PaO2 and SaO2 （r = - 0. 62, r = - 0. 53, P 〈 0. 05） but not correlated with PaCO2 （r = 0. 34, P 〉 0. 05）. There were positive correlations between Borg scale and P0. i （ r = 0. 63, P 〈 0. 05） and between P0.1 / P IMAX and REE （ r = 0. 41, P 〈 0, 05）. There was no correlation between P0.1 and FVC, FEV1%, RV/TLC, DLCO, and RQ, respectively. Conclusion： The increase of P0.1 is not only related with PaO2 and SaO2 but also related with the resting energy expenditure and Borg scale in COPD patients.