Chronic bronchitis leads to accelerated hyperinflation in COPD patients during exercise
Chronic bronchitis leads to accelerated hyperinflation in COPD patients during exercise
复制标题
慢性支气管炎导致慢性阻塞性肺病患者在运动期间加速过度充气
DOI：
10.1111/resp.12504
复制
发表时间：
2015-05-01
期刊：
影响因子：
6.9
通讯作者：
Huang, Kewu
中科院分区：
文献类型：
--
作者：
Zhang, Wen;Lu, Haitao;Huang, Kewu
背景和目的：方法：对50例年龄匹配的健康对照者、45例无慢性支气管炎（CB-）的COPD患者和37例伴有慢性支气管炎（CB+）的COPD患者进行肺功能测定、6 min步行距离试验和心肺运动试验。结果：CB组与非CB组患者1 s用力呼气量（FEV 1）无显著差异，而与CB组患者1 s用力呼气量（FEV 1）无显著差异。CB+患者具有较低的（V）重叠（O2）中心点CB+和CB-参与者在峰值运动时的潮气量增加相似;然而，CB+患者的呼吸频率（RR）增加。这些患者在较低的工作负荷时，呼气末肺容量与肺总容量的比值（TLC）达到峰值。逐步多元线性回归分析确定慢性支气管炎，FEV 1，一氧化碳弥散量，残留量的比值TLC和血清肿瘤坏死因子-α作为独立的预测峰（V）overdot（O2）。结论：CB显着降低COPD患者的运动能力，因为在运动过程中的动态过度充气。加速的动态过度充气可能导致COPD患者气道和全身炎症增加。
Background and objective: It is not known whether patients with chronic obstructive pulmonary disease (COPD) have a different exercise capacity with (CB+) or without accompanying chronic bronchitis (CB-).Methods: We conducted spirometry, a 6-min walk distance test and cardiopulmonary exercise test in 50 age-matched healthy control subjects, 45 COPD patients without CB (CB-) and 37 COPD patients with CB (CB+). A multiple regression model was established to identify factors independently associated with peak oxygen consumption ((V)overdot(O2)).Results: Patients with and without CB had similar forced expiratory volume in 1 s (FEV1). CB+ patients had a lower (V)overdot(O2)center dot CB+ and CB- participants had similar increases in tidal volume at peak exercise; however, CB+ patients had an increased respiratory rate (RR). These patients reached the peak value for ratio of end-expiratory lung volume to total lung capacity (TLC) at a lower work load. A stepwise multiple linear regression analysis identified chronic bronchitis, FEV1, diffusing capacity for carbon monoxide, the ratio of residual volume to TLC and serum tumour necrosis factor-alpha as independent predictors of peak (V)overdot(O2).Conclusions: CB significantly lowers exercise capacity in COPD patients because of dynamic hyperinflation during exercise. The accelerated dynamic hyperinflation may contribute to increased airway and systemic inflammation in COPD patients.