COPD患者心肺功能运动试验和静态肺功能的对比研究

Comparison of Cardiopulmonary Exercise Test with Resting Pulmonary Function Test in Evaluating Pulmonary Impairment in COPD Patients

【目的】探讨心肺功能运动试验(CPET)和静态肺功能(PFT)在慢性阻塞性肺疾病(COPD)患者中的相关性及CPET在COPD患者病情评价中的作用。【方法】纳入98名确诊为COPD处于稳定期患者,记录呼吸困难分级(MRC)后并给予PFT和CPET。记录PFT参数为第一秒用力肺活量(FEV1)、FEV1%(占预计值%)、FEV1/FVC。CPET参数为运动功率(W)、公斤摄氧量(VO2/Kg)、氧脉搏(VO2/HR)、心率(HR)、每分钟通气量(VE)、呼吸储备(BR)。比较各CPET参数和PFT参数之间的相关性以及某些参数与呼吸困难分级之间的相关性。CPET中监测患者SO2并记录出现低氧血症例数(SO2<85%)。【结果】①FEV1、FEV1%、FEV1/FVC与W、VO2/Kg呈低到中度相关,与VE、BR呈中到高度相关,而与VO2/HR、HR无相关性。②W、VO2/Kg与呼吸困难分级的相关性要高于FEV1%与呼吸困难分级的相关性。③CPET中5例出现患者低氧血症。【结论】CPET与PFT在COPD患者中有一定的相关性。CPET某些参数与患者的呼吸困难分级有更好的相关性。CPET有助于发现COPD患者运动中的低氧血症。

[Objective] To analyze the correlation and different usage between cardiopulmonary exercise test （CPET） and resting pulmonary function test （PFT）in evaluating pulmonary function in the chronic obstructive pulmonary disease （COPD） patients. [Methods]The modified medical research council dyspnea scale was applied to assess the severity of dyspnea in the 98 stable COPD patients. CPET and PFT were performed in all patients. The parameters in the PFT such as forced expiratory volume in one second （FEV1）, FEV1% （FEV1/predicted FEV1）, and FEV1/FVC （FEV1/ forced vital capacity） were recorded as well as the parameters in CPET such as work rate （W）, oxygen uptake per kilogram of body weight （VO2/kg）, oxygen uptake per beat （VO2/HR）, heart rate （HR）, ventilation （VE） and breathing reserve （BR）. Correlations between the parameters in CPET and those in PFT were analyzed. The correlation between some of the foregoing parameters and the dyspnea scale were analyzed. The SO2 was monitored during CPET and the hypoxemia patients were figure out if the SO2 was lower than 85 %. [Results]①FEV1, FEV1% and FEV1/FVC had low to middle positive correlation with W and VO2/Kg whereas they had middle to high correlation with VE and BR, and they had no correlations with VO2/HR and HR. ②W and VO2/kg had higher correlation with dyspnea scale than FEV1% did. ③CPET figured out 5 hypoxemia patients. [Conelusion]Some parameters in CPET are correlated with those in PFT. Some parameters in CPET have better correlations with dyspnea scale than those in PFT. CPET can help figure out the potential hypoxemia patients during exercising.