慢性阻塞性肺疾病在峰值运动时的心肺运动试验改变特点

Changing characteristics of cardiopulmonary exercise test in chronic obstructive pulmonary diseases patients when peak exercising

目的研究各级慢性阻塞性肺疾病（COPD）患者在峰值运动时的心肺运动试验（CPET）变化特点。方法对102例稳定期男性COPD患者和31名健康男性做常规肺功能和CPET检测。记录常规肺功能参数包括：用力肺活量（FVC）、用力肺活量占预计值的百分比（FVC％pred）、第1秒用力呼气容积（FEV1）、第1秒用力呼气容积占预计值的百分比（FEV，％pred）、一秒率（FEV1／FVC％）、最大通气量占预计值的百分比（MVV％pred）；CPET参数包括峰值运动时的：功率（peakLoad）、功率占预计值的百分比（peakLoad％pred）、摄氧量占预计值的百分比（peak^·O2％pred）、公斤摄氧量（peak^·VO2／kg）、分钟通气量（peak^·VE）、运动心率（peakHR）、氧脉搏（peakOzpulse）。比较各级COPD患者的各项参数与正常对照组的差异。结果轻度COPD组的peakLoad较对照组明显下降（P〈O．05），其余CPET参数则差异无统计学意义。中度COPD组的peakLoad、peakI，oad％pred、peak^·VO2／kg、peakVE及peakHR较对照组显著降低，而peak^·VO2％pred与peakOzpulse较对照组差异无统计学意义。重度COPD组峰值运动时各参数（peakLoad，peakLoad％pred、peak^·VO2％pred、peak^·VO2／kg、peak^·VE、peakHR、peakO2pulse等）均较对照组显著降低（P〈0．01）。结论各级COPD患者在峰值运动时的CPET各项参数变化并不一致，完善CPET参数可对COPD现有的严重程度分级作病情评估的补充，有助于及时全面了解病情，早期发现并发症，并指导后续治疗。

Objective To study the changing characteristics of cardiopulmonary exercise test （CPET） in chronic obstructive pulmonary diseases （COPD） patients who take peak exercises. Methods 102 stable COPD male patients and 31 healthy men underwent pulmonary function test and CPET. The parameters of pulmonary function test included FVC,FVC %pred,FEV1 ,FEV1 %pred,FEV1/FVC% and MVV% pred. The parameters of CPET included peakLoad, peakLoad % pred, peak ^·V O2 % pred, peak ^·V- O2/kg,peak ^·V E, peakHR and peakO2 pulse. We compared these results between different stages of COPD group and control group. Results There was a significant reduction in peakLoad of patients in mild COPD group in comparison to the control group. The peakLoad, peakLoad% pred, peak ^·VO2/kg, peak ^·V E and peakHR of patients in moderate COPD were significantly reduced compared with those in control group,and all the parameters of CPET were significantly reduced in severe COPD group than those in control group. Conclusions The variations of CEPT parameters in peak excising COPD patients were not identicak The perfection of CPET parameters could improve the existing classification of the COPD condition evaluation, as well as helps the doctors to master patients conditions more thoroughly and find complications earlier. It has great significance in the guidance of patients/ future treatment.