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無断転載禁止 |
| 運動負荷心肺機能検査 |
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| |
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| [肺機能検査] |
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|
VC |
1.45 |
(L) |
CV |
(%) |
|
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MVV: |
27.65 |
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%VC |
70.5 |
(%) |
dN2 |
(%) |
|
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THR: |
147 |
|
|
FVC |
1.32 |
(L) |
TLC |
(L) |
|
|
|
|
%FVC |
64.2 |
(%) |
RV/TLC |
(%) |
|
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|
|
FEV1.0 |
0.79 |
(L) |
DLCO |
|
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%FEV1 |
46.1 |
(%) |
%DLCO |
(%) |
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FEV1.0% |
59.8 |
(%) |
DLCO/VA |
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FEV1/VCp |
38.4 |
(%) |
Vtg |
|
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|
|
|
IC |
0.96 |
(%) |
FRC |
|
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|
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|
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| 【Ｏ2(-)(21%)】 |
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| [心肺機能検査] |
|
|
protocol: |
Ergo漸増 |
|
10 |
Watt |
|
運動時間: |
3分43秒 |
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中止理由: |
息切れ |
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安静時 |
2分後 |
4分後 |
6分後 |
8分後 |
10分後 |
12分後 |
14分後 |
16分後 |
終了時 |
|
|
Watt |
|
10 |
20 |
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| Borg
Scale |
0 |
0 |
1 |
3 |
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6 |
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f |
|
45 |
55 |
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58 |
(/min) |
|
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VT |
|
314 |
353 |
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|
429 |
(ml) |
|
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VE |
|
14.0 |
18.7 |
|
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|
24.4 |
(L/min) |
|
|
VO2 |
|
221 |
363 |
|
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|
489 |
(ml/min) |
|
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VO2/W |
5.4 |
8.9 |
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11.9 |
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VCO2 |
|
182 |
285 |
|
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|
401 |
(ml/min) |
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R |
|
0.82 |
0.79 |
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0.82 |
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VE/VO2 |
63 |
52 |
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50 |
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VE/VCO2 |
77 |
66 |
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61 |
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VD/VT |
0.31 |
0.27 |
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|
0.32 |
|
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HR |
|
73 |
105 |
|
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|
141 |
(/min) |
|
|
VO2/HR |
3.0 |
3.5 |
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3.5 |
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|
METS |
1.5 |
2.5 |
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3.4 |
|
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BP |
|
154/75 |
166/97 |
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|
181/71 |
(mmHg) |
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| [血液ガス検査] |
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|
安静時 |
2分後 |
4分後 |
6分後 |
8分後 |
10分後 |
12分後 |
14分後 |
16分後 |
終了時 |
|
|
pH |
|
7.372 |
7.363 |
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|
7.345 |
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PaO2 |
|
66.9 |
60.6 |
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55.7 |
(mmHg) |
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PaCO2 |
39.6 |
39.5 |
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|
43.1 |
(mmHg) |
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|
HCO3 |
|
22.5 |
22.0 |
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|
22.9 |
(mm/L) |
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BE |
|
-2.0 |
-2.6 |
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|
-2.2 |
(mm/L) |
|
|
SAT |
|
93.6 |
90.7 |
|
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|
|
|
88.5 |
(%) |
|
|
SpO2 |
|
91 |
90 |
|
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|
87 |
(%) |
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|
Lactate |
0.5 |
0.8 |
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|
1.3 |
(mg/dl) |
|
|
NA |
|
1.33 |
1.93 |
|
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|
3.01 |
(ng/ml) |
|
|
Ad |
|
0.28 |
0.31 |
|
|
|
|
|
|
|
|
|
|
|
|
|
0.41 |
(ng/ml) |
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|
[コメント] |
|
|
|
1. |
ECG所見 VPB: なし SVPB:
なし その他: |
|
ST変化: なし 心電図判定: 陰性 |
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2. |
peak VO2は予測値(800ml/min)の 61.1%であり、運動能は低下を示唆する。 |
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3. |
運動中の換気当量(VE/VO2)は健常より大であり、換気効率は低下。 |
|
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|
VEmax/MVV=88.2% 換気パターンは
rapid and shallow pattern |
|
VEmax/VEpred=142.6%(VEpred 17.1 l/min) |
|
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|
4. |
最大運動時のPaO2は55.7mmHgであり、低酸素血症(PaO2<60mmHg)は呈する。 |
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|
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PaO2slope=-4.18 |
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PaCO2slope=1.31mmHg/100mlVO2 |
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|
|
5. |
運動に伴い、HRは健常より大、O2pulse(VO2/HR)は早期に頭打ちであり、心機能は低下を示唆する｡ |
|
|
|
|
|
HRmax/THR=95.9% |
|
|
|
|
6. |
AT(V-slope)= − ml/min |
|
AT(Lactate)= − ml/min |
|
NT= − ml/min |
|
|
|
|
7. |
運動制限因子は 換気低酸素血症 |
|
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<症例66> |
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