乳酸阈测定在中重度COPD患者康复治疗中的应用价值

The clinical significance of blood lactate for pulmonary rehabilitation in patients with moderate to severe chronic obstructive pulmonary disease(COPD)

目的观察乳酸阈测定在中重度COPD患者康复治疗中的应用价值。方法选择32例中重度COPD患者行6min步行试验,于试验前后分别测定血乳酸水平,观察低氧血症发生情况。结果试验后血乳酸浓度、心率、肺动脉收缩压较试验前显著增高(P<0.001),SpO_2显著降低(P<0.01);9例出现低氧血症,其血乳酸浓度及肺动脉收缩压显著升高,6min步行距离显著缩短。Pearson相关分析显示,血乳酸与肺动脉收缩压呈正相关,与SpO_2呈负相关(r=0.515和-0.575,P均<0.01)。结论血乳酸浓度是评价中重度COPD患者康复治疗运动强度的重要指标。

[ Objective ] To observe the change of blood lactate before and after 6-minute walk test （6MWT） in patients with moderate to severe COPD, so as to explore the exercise intensity in pulmonary rehabilitation. [ Methods] Totally 32 patients with moderate to severe COPD participated in the 6-minute walk test. The blood lactate.heart rate.SpO2 .pulmonary anterial systolic pressure were measured before and after exercise. [ Results] After 6MWT,The 32 COPD patients showed a significant increase in blood lactate ,heart rate .pulmonary arterial systolic pressure , and decrease in SpO2 （ P 〈 0. 001, P 〈 0.01 ） . In Pearson correlation analysis , blood lactate with pulmonary arterial systolic pressure was positive correlated , While negetive correlated with SpO2 （ r = 0. 515, r = - 0. 575 ;P 〈 0. 01, P 〈 0. 01）. [ Conclusion] The detected of blood lactate was a potential predictor that evaluate of exercise intensity for pulmonary rehabilitation in patients with moderate to severe COPD.