Dynamic hyperinflation and dyspnea during the 6-minute walk test in stable chronic obstructive pulmonary disease patients.
Dynamic hyperinflation and dyspnea during the 6-minute walk test in stable chronic obstructive pulmonary disease patients.
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DOI：
10.2147/copd.s73717
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发表时间：
2015
影响因子：
2.8
通讯作者：
Kawagoshi A
中科院分区：
文献类型：
--
作者：
Satake M;Shioya T;Uemura S;Takahashi H;Sugawara K;Kasai C;Kiyokawa N;Watanabe T;Sato S;Kawagoshi A
本研究的目的是探讨慢性阻塞性肺疾病患者动态高充气与呼吸困难的关系，探讨慢性阻塞性肺疾病患者6分钟步行试验(6MWT)呼吸困难的特点。23例稳定期中度慢性阻塞性肺疾病患者，年龄(73.8±5.8)岁，均为男性。在6MWT期间，使用便携式呼吸气体分析系统测量呼吸机参数和气体交换参数。在测试期间每2分钟结束时记录呼吸困难和血氧饱和度。在6MWT过程中，吸气量显著下降。这表明，动态恶性通货膨胀已经发生。呼吸困难呈显著线性增加，与吸气量呈显著负相关。提示6MWT时发生呼吸困难的原因之一是动态过度充气。尽管潮气量在2min后几乎没有增加，但呼吸困难在6MWT结束时呈线性增加。这些结果表明，在6MWT中呼吸困难的发生机制是早期的呼吸用力感觉，然后是中枢运动指令输出与呼吸系统运动的不匹配。
The purpose of this study was to investigate the relationship between dynamic hyperinflation and dyspnea and to clarify the characteristics of dyspnea during the 6-minute walk test (6MWT) in chronic obstructive pulmonary disease patients. Twenty-three subjects with stable moderate chronic obstructive pulmonary disease (age 73.8±5.8 years, all male) took part in this study. During the 6MWT, ventilatory and gas exchange parameters were measured using a portable respiratory gas analysis system. Dyspnea and oxygen saturation were recorded at the end of every 2 minute period during the test. There was a significant decrease in inspiratory capacity during the 6MWT. This suggested that dynamic hyperinflation had occurred. Dyspnea showed a significant linear increase, and there was a significant negative correlation with inspiratory capacity. It was suggested that one of the reasons that dyspnea developed during the 6MWT was the dynamic hyperinflation. Even though the tidal volume increased little after 2 minutes, dyspnea increased linearly to the end of the 6MWT. These results suggest that the mechanisms generating dyspnea during the 6MWT were the sense of respiratory effort at an early stage and then the mismatch between central motor command output and respiratory system movement.