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目的探讨COPD引起的慢性肺心病患者心肺运动试验(CPET)的特点。方法对在1997年11月～2003年11月期间,于广东省人民医院肺功能室行CPET检查的5例慢性肺心病患者及12例COPD患者的结果进行回顾性分析。结果 (1)慢性肺心病组5例患者运动耐量均降低,2例患者运动未达无氧阈;COPD组8例患者运动耐量降低,所有患者运动均达无氧阈。(2)慢性肺心病组运动时间、最大运动功率(Wmax)、氧脉(O_2pulse)、氧脉占预计值百分比(O_2pulse pred%)、峰值摄氧量((?)O_2peak)、峰值公斤摄氧量((?)O_2peak/kg)、峰值摄氧量占预计值百分比((?)O_2peak pred%)、运动后动脉血氧分压(PaO_2后)低于COPD组,休息和最大运动时无效腔与潮气量的比值(VD/VT rest、VD/VTpeak)、最大运动时的氧通气当量((?)E/(?)O_2peak)及二氧化碳通气当量((?)E/(?)CO_2peak)高于COPD组,差异有显著性(P<0.05)。结论 COPD引起的慢性肺心病患者运动能力明显低于COPD患者,且运动同时受限于呼吸和心血管功能。通气血流比例(VA/Q)不均较COPD患者严重,表现为VD/VT rest、VD/VTpeak、(?)E/(?)O_2、(?)E/(?)CO_2明显高于正常,易发生运动后低氧血症。
Objective To investigate the characteristics of cardiopulmonary exercise test (CPET) in patients with chronic cor pulmonale caused by COPD. Methods The clinical data of 5 patients with chronic cor pulmonale and 12 patients with chronic obstructive pulmonary disease undergoing CPET in the lung function room of Guangdong Provincial People’s Hospital from November 1997 to November 2003 were analyzed retrospectively. Results (1) The exercise tolerance of 5 patients with chronic cor pulmonale was decreased, while 2 patients did not reach the anaerobic threshold. The exercise tolerance of 8 patients in COPD group was decreased, and all the patients reached the anaerobic threshold. (2) Wmax, O_2pulse, O_2pulse pred%, peak oxygen uptake (O 2peak), peak kilogram uptake of oxygen in chronic pulmonary heart disease group The peak oxygen uptake (%) O_2peak pred% was lower than that of the COPD group (P <0.05), and the resting and maximal motility null chamber The ratio of tidal volume to tidal volume (VD / VT rest, VD / VTpeak), maximum ventilatory oxygen equivalent (?) E / ()) O 2peak and carbon dioxide aeration (/) E / (CO 2peak) In COPD group, the difference was significant (P <0.05). Conclusion The exercise capacity of patients with chronic cor pulmonale caused by COPD is significantly lower than that of patients with COPD, and exercise is limited by both respiratory and cardiovascular functions. The mean VA / Q ratio was significantly higher than that of COPD patients with VD / VT rest, VD / VTpeak, (?) E / (?) O_2 and (?) E / , Prone to hypoxemia after exercise.