慢性閉塞性心不全の患者の呼吸器筋機能と呼吸不全
D M Mancini1, D Henson, J LaManca
1Cardiovascular Section, Philadelphia Veterans Administration Medical Center, Pa.
Circulation
|September 1, 1992
まとめ
心不全の患者は,低頻度の疲労ではなく,膜の働きが増加したために呼吸不全を経験します. 副呼吸器の筋肉は,運動中に脱酸素を示し,呼吸不全の重度と相関しています.
科学分野:
- 心臓病学 心臓病学
- 呼吸器医学とは
- 運動生理学 運動生理学
背景:
- 心不全 (HF) の患者は,運動中に呼吸困難を経験することが多い.
- 以前の研究では,近赤外線スペクトロスコピーを用いて,HF患者の呼吸器筋肉の補助的な脱酸素化を示した.
研究 の 目的:
- 運動中に心不全患者の低頻度呼吸器筋疲労が発生するかどうかを調査する.
- 呼吸器の筋肉機能,酸素供給,呼吸不全の感覚との関係を調査する.
主な方法:
- 10人のHF患者と6人の対照群で,最大運動前のおよび後の,超最大双方の皮膚経由のフレーニック神経刺激.
- 隔膜機能の測定 (最大圧力,収縮/リラックス率),呼吸器の筋肉の働き (テンション時間指数,TTdi),および筋肉の酸素化のための近赤外線スペクトル検査 (NIRS).
- 呼吸不全の評価と生理学的パラメータの相関分析.
主要な成果:
- 隔膜機能は,両方のグループで運動後の変化がありませんでした.
- 心不全の患者は,休息状態とピーク運動状態で, significantly higher diaphragmatic work (TTdi) を示した.
- 副呼吸器の筋肉は,ピーク運動中にHF患者のみで有意な脱酸素化を示した.
- 呼吸不全の重度は,膜作業,呼吸器の筋肉の強さ,およびNIRS由来の酸素化変化と強く相関しています.
結論:
- 運動中のHF患者では,補助的な筋肉脱酸素化にもかかわらず,低頻度の膜筋疲労は発生しません.
- HF患者における膜作業の増加 (TTdi) は,疲労を引き起こすことが知られているレベルに近づいています.
- HFにおける呼吸不全の感覚は,全体的な呼吸器の筋肉機能と酸素状態と密接に関連しています.
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