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目的：探讨运动时低氧血症与静息时常规肺功能和血气分析指标、运动后呼吸生理改变及最大运动能力的关系。方法：３０ 例稳定期中重度慢性阻塞性肺疾病（ＣＯＰＤ）患者，运动前进行肺功能检查和血气分析。应用自行车功率仪进行递增负荷运动试验，运动过程通过呼吸感应性体表描记仪监测胸腹呼吸运动之和与潮气量之比（ＴＣＤ／ＶＴ） 。结果：３０ 例受试者中１４ 例运动时出现低氧血症，其常规肺功能指标和最大运动能力指标均显著低于其余１６例。极量运动时血氧饱和度（ＳａＯ２ｍｉｎ） 与静息时ＰａＣＯ２ 和ＲＶ／ＴＬＣ 显著负相关，与ＦＥＶ１ ％ ｐｒｅｄ 、ＦＶＣ％ ｐｒｅｄ、ＭＶＶ％ ｐｒｅｄ 和ＰａＯ２ 等均有一定的相关性；极量运动时ＳａＯ２ 下降幅度与静息时ＰａＣＯ２ 、ＰａＯ２ 和ＲＶ 显著相关；ＳａＯ２ｍｉｎ与ＴＣＤ／ＶＴ 的变化负相关；ΔＳａＯ２ 与ＶＥｍａｘ 相关；ＳａＯ２ｍｉｎ 和ΔＳａＯ２ 与最大运动能力指标无明显的相关性。结论：ＣＯＰＤ患者运动时可出现低氧血症，肺充气过度和通气功能损害是引起运动时低氧血症的主要因素，运动时诱发的胸腹矛盾呼吸和运动时通气不足对低氧血症的发生有一定的影响；运动时低氧血症与最大运动能力无明显的相关性。
Objective: To investigate the relationship between hypoxemia during exercise and routine pulmonary function and blood gas analysis at rest, respiratory physiological changes after exercise and maximal exercise capacity. Methods: Thirty patients with stable chronic moderate-to-severe obstructive pulmonary disease (COPD) underwent exercise tests and blood gas analysis before exercise. The bicycle power meter was used to carry out incremental load exercise test. The exercise was monitored by breath-sensitive surface chart instrument for TCD / VT. Results: Hypoxemia was found in 14 of the 30 subjects during exercise, and the indexes of pulmonary function and maximum exercise capacity were significantly lower than the other 16 patients. Oxygen saturation (SaO2min) was significantly and negatively correlated with resting PaCO2 and RV / TLC at rest, and correlated with FEV1% pred, FVC% pred, MVV% pred and PaO2, SaO2 decreased significantly with resting PaCO2, PaO2 and RV; SaO2min negatively correlated with TCD / VT; ΔSaO2 correlated with VEmax; SaO2min and ΔSaO2 had no significant correlation with maximum exercise capacity. CONCLUSIONS: Hypoxemia may occur during exercise in COPD patients. Excessive lung hyperinflation and impairment of ventilatory function are the main factors that cause hypoxemia during exercise. Contraindications of chest-stomach contractions and hypopnea during exercise induced hypoxemia Had a certain impact on the occurrence; exercise hypoxemia and maximum exercise capacity no significant correlation.