COMPARISON OF PROGRESSIVE EXERCISE PERFORMANCE OF NORMAL SUBJECTS AND PATIENTS WITH PRIMARY PULMONARY-HYPERTENSION
COMPARISON OF PROGRESSIVE EXERCISE PERFORMANCE OF NORMAL SUBJECTS AND PATIENTS WITH PRIMARY PULMONARY-HYPERTENSION
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DOI：
10.1378/chest.92.1.57
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发表时间：
1987-07-01
期刊：
影响因子：
9.6
通讯作者：
GIANOTTI, LA
中科院分区：
文献类型：
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作者：
DALONZO, GE;POHIL, RL;GIANOTTI, LA
通过渐进式直立自行车测力法研究了 11 名原发性肺动脉高压 (PPH) 患者的运动限制程度及其机制。所有患者的平均肺动脉压为30毫米汞柱或更高（平均56±15），肺功能测试正常，肺毛细血管楔压正常，肺血管造影与诊断一致。将 PPH 患者的休息和运动数据与 11 名匹配的久坐对照受试者的数据进行了比较。平均最大耗氧量 (.ovrhdot.VO2) 为 13 .+-。 PPH 组为 4 ml/kg/min，相比之下为 28.+-。对照组为 7 毫升/公斤/分钟。在最大 .ovrhdot.VO2 时，每分钟通气量 (.ovrhdot.VE) 相似；然而，PPH 组在休息和运动期间任何二氧化碳产生水平 (.ovrhdot.VCO2) 的 (.ovrhdot.VE) 均显着较高。对照组的最大心率和氧脉搏（.ovrhdot.VO2/心率）显着较高（分别为 148.+-.18 vs 180.+-.24，以及 6.3.+-.2.2 vs 9.9.+-.3.9）。 PPH 组的无氧阈值在渐进运动过程中出现较早，并且与 PPH 患者达到的最大氧脉冲呈正相关。总之，PPH 患者由于心血管因素而存在严重的运动受限，无法在运动过程中维持适当的氧气输送至身体。未发现呼吸障碍；然而，我们发现任何 (.ovrhdot.VCO2) 水平的运动都会产生过度的通气反应。
The extent of exercise limitation and the mechanisms for that limitation in 11 patients with primary pulmonary hypertension (PPH) were studied by progressive, upright cycle ergometry. All patients had a mean pulmonary artery pressure of 30 mm Hg or higher (mean, 56 .+-. 15), normal pulmonary function testing, normal pulmonary capillary wedge pressure, and pulmonary angiography consistent with the diagnosis. Rest and exercise data obtained from the patients with PPH were compared with data obtained from 11 matched, sedentary control subjects. Mean maximal oxygen consumption (.ovrhdot.VO2) was 13 .+-. 4 ml/kg/min in the PPH group compared with 28 .+-. 7 ml/kg/min in the controls. At maximal .ovrhdot.VO2 the minute ventilation (.ovrhdot.VE) was similar; however, the (.ovrhdot.VE) at any level of carbon dioxide production (.ovrhdot.VCO2) during rest and exercise was significantly higher in the PPH group. Maximal heart rate and oxygen pulse (.ovrhdot.VO2/heart rate) was significantly higher in the control group (148 .+-. 18 vs 180 .+-. 24, and 6.3 .+-. 2.2 vs 9.9 .+-. 3.9, respectively). Anaerobic threshold occurred earlier during progressive exercise in the PPH group and correlatived positively with the maximal oxygen pulse achieved in patients with PPH. In conclusion, patients with PPH have severe exertional limitation due to cardiovascular factors with an inability to maintain appropriate oxygen delivery to the body during exercise. No respiratory impairment was recognized; however, an exaggerated ventilatory response to exercise at any level of (.ovrhdot.VCO2) was found.