Inspiratory capacity, dynamic hyperinflation, breathlessness, and exercise performance during the 6-minute-walk test in chronic obstructive pulmonary disease
Inspiratory capacity, dynamic hyperinflation, breathlessness, and exercise performance during the 6-minute-walk test in chronic obstructive pulmonary disease
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DOI：
10.1164/ajrccm.163.6.2003172
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发表时间：
2001-05-01
影响因子：
24.7
通讯作者：
Celli, BR
中科院分区：
文献类型：
--
作者：
Marin, JM;Carrizo, SJ;Celli, BR
重度慢性阻塞性肺疾病（COPD）患者在踏车和跑步机上进行极限递增和恒定的负荷运动时，会发生动态肺过度充气（DH）。呼气末肺容量的增加似乎是呼吸困难的最佳预测指标。DH的定量是基于相对复杂的使用，从流量环路在线测量吸气量（IC）。我们推断，DH可能发生在日常活动中，如步行，它可以简单地测量使用呼吸测定IC。我们研究了72名COPD男性患者（FEV 1 = 45 +/- 13.3%预测值）。在休息时和6分钟步行试验后测量IC。使用博格量表评价呼吸困难，使用改良医学研究理事会（MRC）量表评价日常活动期间的呼吸困难。IC从休息时的28.9 +/-6.7%TLC显著降低至运动后的24.1 +/-6.8%TLC（p < 0.001）。呼吸困难与IC（r =-0.49，p < 0.00001）和基线MRC（r = 0.59，p < 0.00001）相关。在许多COPD患者中，步行导致DH，这可以通过简单的肺功能检测轻松确定。DH有助于解释简单日常活动中的运动能力限制和呼吸困难。
Patients with severe chronic obstructive pulmonary disease (COPD) develop dynamic lung hyperinflation (DH) during symptom-limited incremental and constant work exercise with cycle ergometer and treadmill. The increase in end-expiratory lung volume seems to be the best predictor of dyspnea. Quantification of DH is based on the relatively complex use of on-line measurement of inspiratory capacity (IC) from flow volume loops. We reasoned that DH could occur during daily activities such as walking, and that it could be simply measured using the spirometrically determined IC. We studied 72 men with COPD (FEV1 = 45 +/- 13.3% predicted). IC was measured at rest and after a 6-min walk test. Exertional dyspnea was evaluated using the Borg scale and dyspnea during daily activities with the modified Medical Research Council (MRC) scale. IC decreased significantly from 28.9 +/- 6.7% TLC at rest to 24.1 +/- 6.8% TLC after exercise (p < 0.001). Exertional dyspnea correlated with IC (r = -0.49, p < 0.00001) and baseline MRC (r = 0.59, p < 0.00001). In many patients with COPD, walking leads to DH that can be easily determined with simple spirometric testing. DH helps explain exercise capacity limitation and breathlessness during simple daily activities.