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本研究的目的是通过在最大运动量期间,用三种方法对正常者(n=13)及轻度(n=11)、中度(n=5)、重度(n=6)慢性空气流量受限者(CAL,FEV1/FVC,39%-68%)的机械通气限度进行评估。为了评估机械通气限度,将最大运动量时的通气量(VEmax)与最大的自主换气量(MVV)[即计算的运动通气最大值(VEmaxcal)]进行比较。此比值与FEV1×37.5的和就是机械通气限度。所有受试者均用梯度循环测力法进行测定。肺功能和评价方法之间存在着显著的相关性(P<0.001)。当与正常受试者的肺功能相比,只有重度CAL的机械通气限度[即VEmax/MVV(%)]是显著增高的(83%VS62%,P<0.05);与正常肺功能受试者相比,所有CAL受试者的VEmax/VEmaxcal(%)均有所增高,VEmax/FEV1×37.5(%)在轻重度CAL受试者中也有所增高(P<0.05)。在轻重度CAL受试者中,机械通气度VEmax/MVV(%)比VEmax/VEmaxcal(%)(P<0.05)以及VEmax/FEV1×37.5(%)(P<0.001)有所降低。这些数据表明:在评估机械通气限度时,用VEmax/VEmax和VEmax/FEV1×37.5进行计算比用VEmax/MVV计算所得值大,这种趋势在轻中度CAL受试者中更为明显。据此得出的结论是:机械通气限度的评估可以受到肺功能和VEmax变异度两方面的影响。
The purpose of this study was to assess the effect of chronic air flow on normal subjects (n = 13) and mild (n = 11), moderate (n = 5), and severe The limit of mechanical ventilation (CAL, FEV1 / FVC, 39% -68%) was assessed. To assess the mechanical ventilation limit, the maximum amount of ventilation (VEmax) and the maximum amount of voluntary ventilation (MVV) [calculated maximum ventilation (VEmaxcal)] are compared at maximum exercise. The ratio and the sum of FEV1 × 37.5 is the mechanical ventilation limit. All subjects were measured by gradient cyclic force test. There was a significant correlation between lung function and evaluation method (P <0.001). The mechanical ventilation limit (ie VEmax / MVV (%)] of only severe CALs was significantly higher (83% VS62%, P <0.05) compared to the lung function of normal subjects; VEmax / VEmaxcal (%) was increased in all CAL subjects, and VEmax / FEV1 × 37.5 (%) was also increased in subjects with mild and severe CAL (P <0.05). Mechanical ventilation VEmax / MVV (%) decreased from VEmax / VEmaxcal (%) (P <0.05) and VEmax / FEV1 × 37.5 (%) (P <0.001) in subjects with mild and severe CAL. These data indicate that when assessing mechanical ventilation limits, the calculation with VEmax / VEmax and VEmax / FEV1 × 37.5 is greater than with VEmax / MVV, a trend that is more pronounced in mild-to-moderate CAL subjects. This concludes that assessment of mechanical ventilation limits can be affected both in terms of lung function and VEmax variability.