COPD患者流速容量环及其与运动能力的关系

The Volume Loops and Their Relationship with Exercising Capacity of COPD Patients

目的：探讨慢性阻塞性肺疾病（ＣＯＰＤ）患者呼吸运动方式和运动受限的原因。方法：ＣＯＰＤ患者在功率自行车上运动至最大运动量，观察其潮气流速容量环的变化特点，并利用相关和逐步回归分析判断运动中最大公斤耗氧量（ＶＯ２ｍａｘ／ｋｇ）与静态最大流速容量环呼气流速间的关系。结果：１ＣＯＰＤ患者运动中潮气流速容量环的变化有其特点；２ＣＯＰＤ患者最大公斤耗氧量与Ｖ７５％、Ｖ５０％和Ｖ２５％呈显著正相关（ｒ分别为０．８５７，０．８７５和０．７８９，Ｐ＜０．０１）；３ＣＯＰＤ患者ＶＯ２ｍａｘ／ｋｇ与Ｖ５０％存在直线回归关系ｔ＝６．３７３，Ｐ＜０．０１。结论：１ＣＯＰＤ患者的特殊呼吸方式为运动中潮气流速容量环逐渐向肺总量位附近偏移；２静态Ｖ５０％减小是ＣＯＰＤ患者运动受限的主要原因。

Objective:To look for breathing strategy and limitation causes with COPD patients during exercise. Methods:The patients were performed cardiopulmonary exercising testing (CPET) using erogmeter bicycle. We observed changes in the exercising tidal flow-volume loop, and then analyzed the relationship between the maximal flow-volume loop and patients?exercising capacities. Results: (1) The change of the exercising tidal flow-volume loop with COPD patients had its characteristics. (2) The patients?maximal V02 correlated with V75%, V50% and V25% ( r= 0.857, 0.875 and 0.789 respectively, P<0.01). (3) The patients?VO2max had linear regression relationship with V50% (t=6.373, P<0.0l). Conclusion: (1) The characteristics of the patient ?s tidal flow-volume loop during exercising had a tendency to come close to the total lung capacity. (2) The decrease of V50% was the main cause of exercising limitation.