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首页> 外文期刊>Sarcoidosis, vasculitis, and diffuse lung diseases: official journal of WASOG >Impaired exercise response in sarcoid patients with normal pulmonary functio.
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Impaired exercise response in sarcoid patients with normal pulmonary functio.

机译：肺功能正常的结节病患者的运动反应受损。

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BACKGROUND AND AIM OF THE WORK: Sarcoidosis is a granulomatous disease with frequent pul monary involvement. Patients generally exhibit a 25-30% reduction in maximal aerobic capacit (VO2max). As most investigations have included patients with both normal and abnormal resting pulmonary function tests (PFT), the mechanisms responsible for this limitation remain unclear. We initiated a prospective study to characterize the cardio-respiratory response to exercise in sarcoid patients with normal resting PFT. METHODS: 19 untreated male patients with biopsy-proven sarcoidosis and 19 age- an sex-matched sedentary healthy controls (38 +/- 8.7 vs 37 +/- 8.7 yrs ; Body Mass Index: 24 +/- 3.05 vs 23 +/- 3.05) were included in the study. All patients had normal resting PFT including diffusing capacity for CO (DLCO) > 80% predicted and normal cardiac status at rest as assessed by EKG and echocardiography. A maximal cycling test was performed in all subjects. RESULTS: True maximal effort was obtaine in all subjects (plasma lactate 9.1 +/- 2.6 vs 11.0 +/- 2.2 mmol l(-1), pH 7.35 +/- 0.04 vs 7.34 +/- 0.04) (patients vs controls). Patients exhibited a 30% lower maximal workload and/or VO2max (2,128 +/- 413 vs 2,909 +/- 387 ml x min(-1)) than controls. Maximal ventilation (79 +/- 21.7 vs 110 +/- 21.7 l x min(-1)) and tital volume (VT) (2,313 +/- 517 ml vs 2,856 +/- 339) were significantly lower in patients than in controls while dead space t tital volume ratio (VD/V(T)) (0.18 +/- 0.09 vs 0.11 +/- 0.04) was higher in patients than in controls. PaO2, PAiO2, and PAi-aO2 at VO2max were not significantly different between patient and controls. Peak exercise EKG was normal in all but one patient. Interestingly, heart rate was significantly lower in patients for all relative exercise intensities > or = 60% VO2max including maximum (159 +/- 21.7 vs 182 +/- 13) CONCLUSION: The present observations indicate a significant maximal exercise limitation in sarcoid patients without significant pulmonary impairment which could be related at least in part to an impaired heart rate response to exercise.
机译：工作背景和目的：结节病是一种肉芽肿性疾病，经常累及肺脏。患者的最大有氧能力（VO2max）通常降低25-30％。由于大多数研究都包括了具有正常和异常静息肺功能检查（PFT）的患者，导致这种局限性的机制仍不清楚。我们启动了一项前瞻性研究，以表征静息PFT正常的结节患者对运动的心肺反应。方法：19名未经治疗的经活检证实为结节病的男性患者和19名年龄相匹配的久坐健康对照者（38 +/- 8.7 vs 37 +/- 8.7岁;体重指数：24 +/- 3.05 vs 23 +/- 3.05）包括在研究中。所有患者均具有正常的静息PFT，包括通过心电图和超声心动图评估得出的CO扩散能力（DLCO）> 80％的预测值，以及静息时心脏状态正常。在所有受试者中进行了最大的自行车测试。结果：在所有受试者中获得了最大的努力（乳酸血浆9.1 +/- 2.6 vs 11.0 +/- 2.2 mmol l（-1），pH 7.35 +/- 0.04 vs 7.34 +/- 0.04）（患者vs对照）。与对照相比，患者的最大工作量和/或最大摄氧量降低了30％（2,128 +/- 413对2,909 +/- 387 ml x min（-1））。患者的最大通气量（79 +/- 21.7对110 +/- 21.7 lx min（-1））和滴定体积（VT）（2,313 +/- 517 ml对2,856 +/- 339）明显低于对照组患者的死空间t滴定体积比（VD / V（T））（0.18 +/- 0.09 vs 0.11 +/- 0.04）高于对照组。 VO2max时的PaO2，PAiO2和PAi-aO2在患者和对照组之间无显着差异。除一名患者外，所有患者的峰值运动心电图均正常。有趣的是，所有相对运动强度>或= 60％最大摄氧量（包括最大）的患者的心率均显着降低（最大值（159 +/- 21.7 vs 182 +/- 13））结论：目前的观察结果表明，在没有运动的结节患者中，最大运动极限明显严重的肺功能障碍，这可能至少部分与运动对心率的反应有关。

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