慢性充血性心力衰竭患者的呼吸肌功能和呼吸障碍
D M Mancini1, D Henson, J LaManca
1Cardiovascular Section, Philadelphia Veterans Administration Medical Center, Pa.
Circulation
|September 1, 1992
概括
心力衰竭患者由于隔膜工作增加而出现呼吸障碍,而不是低频疲劳. 辅助呼吸道肌肉在运动期间表现出脱氧,与呼吸障碍严重程度相关.
科学领域:
- 心脏病学 心脏病学
- 呼吸系统医学 呼吸系统医学
- 运动生理学 运动生理学
背景情况:
- 患有心力衰竭 (HF) 的患者在运动时经常经历呼吸短促.
- 之前的研究表明,在使用近红外光谱的HF患者中,辅助呼吸道肌肉脱氧.
研究的目的:
- 为了调查在运动期间心力衰竭患者中是否发生低频呼吸道肌肉疲劳.
- 探索呼吸道肌肉功能,氧化和呼吸障碍的感觉之间的关系.
主要方法:
- 在10名HF患者和6名对照人群中,在最大运动前和之后进行超最大双边皮肤间的神经刺激.
- 测量隔膜功能 (最大压力,收缩/放松速度),呼吸肌肉工作 (张力时间指数,TTdi) 和近红外光谱 (NIRS) 测量肌肉氧化.
- 呼吸障碍评级与生理参数之间的相关性分析.
主要成果:
- 在这两组中,膜功能在运动后保持不变.
- 心力衰竭患者在休息和峰值运动时表现出显著更高的隔膜工作 (TTdi).
- 辅助呼吸道肌肉仅在高峰运动期间在HF患者中显示出显著的脱氧.
- 呼吸障碍的严重程度与隔膜工作,呼吸肌肉强度和NIRS衍生的氧化变化有很强的相关性.
结论:
- 低频隔膜肌筋疲劳在运动期间不会在HF患者中发展,尽管辅助肌肉脱氧.
- 在HF患者中增加的隔膜工作 (TTdi) 接近已知会导致疲劳的水平.
- 在HF中呼吸不良的感觉与整体呼吸肌功能和氧化状态密切相关.
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