COPD的诊断与分级有赖于常规肺功能指标如FEV1%Pred和FEV1/FVC，但部分急性发作的患者（AECOPD）的肺功能指标无明显下降。2010年我们发现COPD患者静息与运动状态中的呼吸中枢驱动有效性均比正常人差（《CHEST》）。最近，我们观察到药物干预前后COPD患者的运动耐量、呼吸中枢驱动和N-末端脑钠肽前体的变化；研究发现吸入噻托溴铵（抗胆碱能药物）会影响呼吸中枢驱动有效性及减少急性发作。呼吸中枢驱动有效性的实质是什么？它能否预测AECOPD？我们假设呼吸中枢驱动有效性可能是预测AECOPD的指标。我们将以具有自主知识产权的膈肌肌电记录技术为基础，通过记录COPD患者静息和不同恒功率运动下的通气、呼吸中枢驱动等指标及吸入噻托溴铵前后N-末端脑钠肽前体浓度的变化，探索呼吸中枢驱动有效性和N-末端脑钠肽前体浓度变化与AECOPD的相关性，为预测AECOPD提供依据并争取一定突破。

Although the diagnosis and classification of COPD is often based on pulmonary function test (especially FEV1%Pred and FEV1/FVC), these indices are often poorly correlated with acute episode of COPD (AECOPD). In 2010 our present study was to evaluate the efficacy of neural respiratory drive in COPD was lower than that in normal. Recently, we observed the effect of medicine on exercise tolerance、neural respiratory drive and N-terminal pro-brain natriuretic peptide . Initial study showed inhale Tiotropium Bromide （anticholinergic agents）can influence the efficacy of neural respiratory drive and reduce the frequency of AECOPD. What is the essence of the efficacy of neural respiratory drive? Does it predict AECOPD? We made a hypothesis that the efficacy of neural respiratory drive possibly acts as an index of prediction of AECOPD. Our present study was to evaluate the changes in ventilation、the efficacy of neural respiratory drive and the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels interfered by Tiotropium Bromide, based on our patented diaphragmatic electromyogram technology, under various constant work load exercise protocols. We hoped to found the essence of efficacy of neural respiratory drive and the effect of concentration change of NT-proBNP on AECOPD. We strived to supply science evidence for prediction of AECOPD and take invariably breakthrough.