稳定期慢性阻塞性肺疾病病人吸入支气管舒张剂后深吸气量与运动耐量的关系

Association between inspiratory capacity and exercise torlerance,after bronchodilators inhalation in patients with stable chronic obstructive pulmonary disease

目的探讨稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)病人吸入支气管舒张剂后深吸气量(inspiratory capacity,IC)与运动耐量的关系。方法对42例稳定期COPD病人进行常规肺功能检测和6 min步行试验(six-minute walk test,6MWT),以6 min步行距离(6MWD)和Borg评分来评价病人的运动耐量和呼吸困难程度;病人吸入复方异丙托溴胺2.5 ml(沙丁胺醇3 mg/异丙托溴胺500μg)后复查肺功能和6MWT,探讨IC与运动耐量的关系。结果吸入复方异丙托溴胺后,第1秒用力呼气量(FEV1)、用力肺活量(FVC)、IC、残气量(RV)、功能残气量(FRC)和肺总量(TLC)及6MWD均有显著的改善,但仅IC的增加(△IC%)与6MWD的增加(△6MWD)和运动后Borg呼吸困难评分的改善(△Borg步行后)之间存在显著相关性。结论支气管舒张剂治疗后IC的增加与病人运动耐量和呼吸困难的改善密切相关。

Objective To study the association of inspiratory capacity（ IC） and exercise torlerance,after bronchodilators inhalation in patients with stable chronic obstructive pulmonary disease（ COPD）. Methods Forty-two stable COPD patients were underwent pulmonary function test and sixminute walk test（ 6 MWT） on the baseline and after salbutamol/ipratropium（ salbutamol 3 mg and ipratropium 500 μg） inhalation. Six-minute walk distance（ 6 MWD） and the score of Borg dyspnea scale was used to evaluate the exercise tolerance and the degree of dyspnea. Results After salbutamol/ipratropium（ salbutamol 3 mg and ipratropium 500 μg） inhalation,the forced expiratory volume in one second（ FEV1） 、forced vital capacity（ FVC） 、IC、residual volum（ RV） 、functional residual capacity（ FRC） 、total lung capacity（ TLC） and 6 MWD were significantly improved than those before inhalation.But only the change of IC correlated strongly with the improvement of 6 MWD and the score of Borg dyspnea. Conclusions Changing of IC after bronchodilators is associated with the improvement of exercise torlerance and exertional dyspnea.