性别差异对中重度慢性阻塞性肺疾病患者运动耐力的影响

摘要

目的 比较中重度慢性阻塞性肺疾病(COPD)患者运动耐力的性别差异.方法 本研究对151例中、重度COPD患者的肺功能(PFT)和功率递增心肺运动试验(CPET)结果进行了分析.将患者分为Ⅱ级COPD组和Ⅲ级COPD组.并选择43例年龄、性别、身高、体质量相匹配的正常人作为对照组.本研究测定第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、峰值运动功率(Peak Load)、峰值摄氧量(Peak (V)O2)、峰值心率(Peak HR)、峰值氧脉搏(Peak(V)O2/HR)、最大分钟通气量(M(V)E)、气促指数(M(V)E/MVV)等指标.本研究分别在不同COPD分级和性别之间分析比较了上述指标的差异.结果 Ⅱ级COPD组和Ⅲ级COPD组的女性患者的Peak (V)O2实/预％和Peak (V)O2/HR实/预％较同组男性更高(P值均＜0.05).Ⅲ级COPD男性患者的运动耐力较Ⅱ级有明显降低(P＜0.0001),然而,Ⅲ级、Ⅱ级COPD女性患者之间运动耐力差异无统计学意义(P=0.246).结论 在中、重度COPD患者中,男性运动耐力下降较女性更为严重,吸烟可能是造成这一差异的重要因素.%Objective To compare gender differences in exercise capacity of patients with moderate and severe chronic obstructive pulmonary disease (COPD).Methods We examined 151 pulmonary function tests (PFT) and incremental cardiopulmonary exercise testing (CPET) performed in patients with moderate and severe COPD.They were divided into stage Ⅱ and stage Ⅲ COPD group.We enrolled 43 healthy subjects who were matched by age,sex,height,and weight as a control group.We measured FEV1,FVC,Peak Load,Peak (V)O2,Peak HR,Peak (V)O2/HR,M (V)E,M (V)E/MVV et al.We compared these results between different stages and genders.Results Women in stage Ⅱ and stage Ⅲ had higher Peak (V)O2％ predicted and Peak (V)O2/HR％predicted than men (P＜0.05).There was a significant reduction in exercise capacity for men in stage Ⅲ compared with stage Ⅱ (P＜0.0001),however,there was no significant difference between stage Ⅲ and stage Ⅱ for women (P=0.246).Conclusions Male patients with moderate and severe COPD have a more severe reduction in exercise capacity than female and smoking may be a significant factor contributed to the difference.