中重度慢性阻塞性肺病和特发性间质性肺炎患者运动心肺储备功能的对照研究

Comparison study on cardiopulmonary exercise testing of patients with chronic obstructive pulmonary disease and patients with idiopathic interstitial pneumonia

目的探讨Ⅱ～Ⅲ期的慢性阻塞性肺病（COPD）和特发性间质性肺炎（IIP）患者在运动状态下心肺储备功能、肺通气功能和气体交换功能的异同点。方法选择16例Ⅱ～Ⅲ期的COPD稳定期和15例IIP患者分别作为COPD组、IIP组，并选取15例健康成年人作为对照组，分别对各组进行静息肺功能和运动心肺试验（CPET）检查，并观察运动中相关病理生理学参数指标的变化。结果IIP组患者第一秒用力呼气量、一秒率、第一秒用力呼气量占预计值、每分钟最大通气量、最大运动负荷、每分钟氧耗量、每分钟二氧化碳产生量、氧脉搏、最大运动通气量、呼吸储备和呼吸商水平均较COPD组增高（均P〈005）；IIP组血氧饱和度下降速度较COPD组增快，但达到极量运动的时间却较COPD组延迟（P〈0．05）。结论运动状态下，中重度COPD患者较IIP者心肺储备功能、通气功能和气体交换功能下降明显。

Objective To compare the lung function during exorcise testing of patients with stable chronic obstructive pulmonary disease （CQPD） stage Ⅱ～Ⅲ and patients with idiopathic interstitial pneumonia （IIP）. Methods The study enrolled 16 patients with stable COPD stage Ⅱ～Ⅲ , 15 patients with IIP and 15 healthy adults as controls. Resting lung function and cardiopulmonary exercise testing （CPET） with ramp patter method were performed. All patients and controls were monitored continuously with main pathophysiology parameters. Results Compare to COPD group, liP group was higher in FEV1.0, FEV1.0/ FVC, FEV1.0%pred, MVV, Wmax, VO2, VCO2, O2pulse, VEmax, BR and RQ （P〈0.05）. Though pulse saturation of oxygen in liP patients decreased more quickly, time for ending the test lasted longer （P 〈 0.05）. Conclusion Lung function of COPD patients during exercise testing decreases more markedly than IIP patients; hypoxia may be not the only factor to limit the patients during exercise testing.