慢性閉塞性肺疾患における運動を制限する神経呼吸器駆動と症状
Caroline Jolley1, Yuanming Luo2, Joerg Steier3
1Division of Asthma, Allergy and Lung Biology, King's College London School of Medicine, King's Health Partners, London, UK.
Lancet (London, England)
|August 28, 2015
まとめ
慢性阻害性肺疾患 (COPD) の患者は,運動中に呼吸不全を経験すると,足の疲労によって制限された患者と比較して,神経呼吸力 (EMGdi%max) が高くなります. この発見は,肺のメカニズムを標的とした介入から恩恵を受ける患者を特定するのに役立ちます.
科学分野:
- 肺医学
- 運動 生理学
- 呼吸器のメカニズム
背景:
- COPDの運動能力は,呼吸困難と足の疲労の両方によって制限されます.
- 神経呼吸器駆動 (EMGdi%max) は,呼吸器の筋肉の負荷を定量化し,息切れに関連しています.
研究 の 目的:
- 運動終了時のEMGdi%maxがCOPD患者の呼吸困難と足の疲労によって制限されているかどうかをテストする.
- COPD患者の運動制限の原因を区別する.
主な方法:
- COPD患者における徹底的なサイクルのエルゴメトリで測定されたEMGdi%max,呼吸量,VO2,およびVE/MVV.
- EMGdiの測定のために食道カテーテルを使用した.
- ANOVAを用いて呼吸不全,足の疲労,またはその両方により停止したグループ間の差異を評価した.
主要な成果:
- 運動終了時のEMGdi%maxは,呼吸困難によって制限された患者 (75. 7%) で,足の疲労 (44. 1%) または両方 (74. 1%) よりも有意に高かった.
- 運動終了時の換気,VO2,またはVE/MVVでは,グループ間で有意な差は認められませんでした.
結論:
- COPD患者は,呼吸器の制約により呼吸が困難になるので,神経呼吸器の駆動がほぼ最大になる.
- 運動中にEMGdi%maxを測定することで,周辺筋肉のトレーニングよりも肺のメカニズムを改善することで最適化された患者を特定できます.
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