Exercise tolerance and cardiorespiratory adjustments at peak work capacity in cystic fibrosis.
Exercise tolerance and cardiorespiratory adjustments at peak work capacity in cystic fibrosis.
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囊性纤维化峰值工作能力下的运动耐量和心肺调节。
DOI：
10.1164/arrd.1982.126.2.211
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
I. Nathanson
中科院分区：
文献类型：
--
作者：
G. Cropp;T. P. Pullano;F. Cerny;I. Nathanson
对20例囊性纤维化（CF）患者进行踏车运动试验，测定其运动耐量和最大作功量（PWC）时的心肺功能。结果与静息肺功能测试相关，由肺功能评分（PFS）表示，范围为0（无肺功能障碍）至18（极度功能障碍）。无（PFS小于3）、轻度（PFS 3-7）或中度（PFS 8-12）肺功能障碍的CF患者与正常受试者一样进行运动。当PFS超过12时，PWC平均降低51%，峰值心率（PHR）降低15%，峰值通气量（PVE）降低39%。严重受累患者在PWC（-7.3%）时出现动脉去饱和、CO2潴留（潮气末PCO 2 + 5 mmHg）和PHR/PWC比值增加。在大多数CF患者中，PVE/PWC比值升高，暗示浪费了VE，死腔通气可能增加。结果表明，每当CF中的肺部疾病是先进的，有运动耐量和心肺储备，运动诱导的通气-灌注异常，动脉去饱和，肺泡通气不足的下降。考虑到患有晚期肺病（PFS大于12）的CF患者对运动的异常生理适应，他们应谨慎从事运动训练计划和剧烈体力活动，并且只有在他们的心肺储备和运动调整得到客观评估后才能进行。
Exercise tolerance and cardiorespiratory adjustments at peak work capacity (PWC) were determined in 20 patients with cystic fibrosis (CF) during progressive cycle ergometry. The results were related to resting lung function tests, expressed by a pulmonary function score (PFS) that ranged from 0 (no pulmonary dysfunction) to 18 (extreme dysfunction). Patients with CF with no (PFS less than 3), mild (PFS 3-7), or moderate (PFS 8-12) pulmonary dysfunction exercised as well as normal subjects. When the PFS exceeded 12, PWC was reduced on the average by 51%, peak heart rate (PHR) was reduced by 15%, and peak ventilation (PVE) was reduced by 39%. Severely affected patients developed arterial desaturation at PWC (-7.3%), CO2 retention (end-tidal PCO2 + 5 mmHg), and an increase in the PHR/PWC ratio. In most patients with CF the PVE/PWC ratio was elevated, suggestion wasted VE and a probable increase in dead space ventilation. The results indicate that whenever pulmonary disease in CF is advanced, there are decreases in exercise tolerance and cardiorespiratory reserves, exercise-induced ventilation-perfusion abnormalities, arterial desaturation, and alveolar hypoventilation. In view of the abnormal physiological adaptations to exercise in patients with CF with advanced lung disease (PFS greater than 12), they should engage in exercise training programs and strenuous physical activity with caution and only after their cardiorespiratory reserves and adjustments to exercise have been objectively evaluated.