【摘要】 目的 探討深吸氣量（inspiratory capacity，IC）與慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者臨床特征的相關(guān)性。 方法 2009年12月-2010年6月納入84例穩(wěn)定期COPD患者，測(cè)定6分鐘步行試驗(yàn)（6-minute walk test，6MWT）、圣喬治生活問(wèn)卷評(píng)分（St George′s respiratory questionnaire，SGRQ）及肺功能檢查:第1秒用力呼氣容積（forced expirotovy volume in one second，F(xiàn)EV1）、IC、IC與肺總量（total lung capacity，TLC）比值（IC/TLC）等相關(guān)指標(biāo)，并進(jìn)行相關(guān)性分析。 結(jié)果 6MWT值與FEV1無(wú)明顯直線(xiàn)相關(guān)（r=0.14，P gt;0.1）；6MWT值與FEV1≥60%無(wú)明顯直線(xiàn)相關(guān)（r=0.16，P gt;0.1）；6MWT值與IC值呈正的直線(xiàn)相關(guān)（r=0.317，P lt;0.01）；6MWT值與IC/TLC值呈正的直線(xiàn)相關(guān)（r=0.274，P lt;0.01）；SGRQ值與FEV1呈負(fù)的直線(xiàn)相關(guān)（r=-0.307，P lt;0.01）；SGRQ值與IC值無(wú)直線(xiàn)相關(guān)（r=-0.001，P gt;0.25）；SGRQ值與IC/TLC值無(wú)直線(xiàn)相關(guān)（r=-0.003，P gt;0.25）。 結(jié)論 對(duì)COPD患者，IC比FEV1更準(zhǔn)確地反映患者的運(yùn)動(dòng)耐量的程度，F(xiàn)EV1比IC更準(zhǔn)確地反映患者呼吸困難的嚴(yán)重程度。
【Abstract】 Objective To explore the relationship between the inspiratory capacity (IC) and clinical characters of stable chronic obstructive pulmonary disease (COPD). Methods Between December 2009 and June 2010, 84 patients with stable COPD were enrolled. Lung function (FEV1, IC, IC/TLC) ,6 minute walk-test (6MWT) and St George′s respiratory questionnaire (SGRQ) were examined. The relationship among FEV1, IC, IC/TLC, and the results of 6MWT and SGRQ by Pearson correlation analysis. Results There was no linear correlation between 6MWT and FEV1 （r=0.14，P gt;0.1）, and 6MWT and FEV1≥60% （r=0.16，P gt;0.1）. There was positive correlation between 6MWT and IC （r=0.317，P lt;0.01）, and 6MWT and IC/TLC （r=0.274，P lt;0.01）. There was negative correlation between SGRQ and FEV1 （r=-0.307，P lt;0.01）; and no linear correlation between SGRQ and IC （r=-0.001，P gt;0.25）, and SGRQ and IC/TLC （r=-0.003，P gt;0.25）. Conclusion In stable COPD patients, IC may be more accurate than FEV1 in refection of exercise tolerance while FEV1 may be more sensitive than IC in evaluation of dyspnea.
引用本文： 劉波,汪俊,李可可,劉曉. 慢性阻塞性肺疾病穩(wěn)定期患者深吸氣量臨床特征性研究. 華西醫(yī)學(xué), 2011, 26(12): 1822-1824. doi: 復(fù)制
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- 1. O′Donnell DE,Revill SM, Webb KA. Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary desease[J]. Am J Respir Crit Care Med, 2001, 164(5): 770-777.
- 2. Diaz O, Villafranca C, Ghezzo H, et al. Role of inspiratory capacity on exercise tolerance in COPD patients with and without tidal exoiratory flow limitation at rest[J].Eur Respir J, 2000, 16(2): 269-275.
- 3. 中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)慢性阻塞性肺疾病學(xué)組. 慢性阻塞性肺疾病診治指南[J]. 中華結(jié)核和呼吸雜志, 2007, 30(1): 8-17.
- 4. O′Donnell DE. Assessment of bronchodilator efficacy in symptomatic. COPD: is spirometry useful?[J]. Chest, 2000, 117(suppl 2): 42-47.
- 5. 陳宇清, 周新, 朱東, 等. 穩(wěn)定期Ⅱ、Ⅲ級(jí)慢性阻塞性肺疾病患者的吸氣分?jǐn)?shù)與呼吸肌力研究[J]. 診斷理論與實(shí)踐, 2007, 6(5): 409-411.
- 6. O′Donnell DE, Flüge T, Gerken F, et al Effects cf tiotropium on lung hyperinflation,dyspnoea and exercise to lerance in COPD[J]. Eur Respir J, 2004, 23(6): 832-840.
- 7. 高曉方. 慢阻肺患者:GOLD分級(jí)有待改進(jìn)[N]. 中國(guó)醫(yī)學(xué)論壇報(bào), 2010-09-09(A3).
- 8. 礫石. COPD患者病情越重心腔體積越小[N]. 中國(guó)醫(yī)學(xué)論壇報(bào), 2010 -07-15(A6).
- 9. Man WDC, Mustfa N, Nikotou D, et al. Effects salmeterol on resoiratory muscle activity during exercise in poorly reversible COPD[J]. Thorax, 2004, 59(6): 471-476.
- 10. Gelb AF, Gutierrez CA, Weisman IM, et al. Simplified detection of dynamic hyperinflation[J]. Chest, 2004, 126(6): 1855-1860.
- 11. 陳文彬, 潘祥林, 康熙雄, 等. 診斷學(xué)[M]. 6版. 北京: 人民衛(wèi)生出版社, 2004: 33.
- 12. 蔡伯薔. 提高COPD管理水平, 2010年GSK全國(guó)呼吸專(zhuān)家COPD高峰論壇會(huì)議紀(jì)要[N]. 中國(guó)醫(yī)學(xué)論壇報(bào), 2010-07-29(A17).