|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
無断転載禁止 |
運動負荷心肺機能検査 |
|
|
|
|
|
|
[肺機能検査] |
|
|
|
|
|
|
VC |
1.28 |
(L) |
CV |
(%) |
|
|
|
MVV: |
31.5 |
|
|
|
|
%VC |
64.4 |
(%) |
dN2 |
(%) |
|
|
|
THR: |
147 |
|
|
FVC |
1.10 |
(L) |
TLC |
(L) |
|
|
|
|
%FVC |
55.3 |
(%) |
RV/TLC |
(%) |
|
|
|
|
FEV1.0 |
0.90 |
(L) |
DLCO |
|
|
|
|
|
%FEV1 |
54.2 |
(%) |
%DLCO |
(%) |
|
|
|
|
FEV1.0% |
81.8 |
(%) |
DLCO/VA |
|
|
|
|
|
FEV1/VCp |
45.3 |
(%) |
Vtg |
|
|
|
|
|
IC |
0.96 |
(%) |
FRC |
|
|
|
|
|
|
|
【O2(-)(21%)】 |
|
|
[心肺機能検査] |
|
|
protocol: |
m-Toneyama |
|
Watt |
|
運動時間: |
15分36秒 |
|
中止理由: |
下肢疲労 |
|
|
|
|
|
|
|
安静時 |
立位時 |
1分後 |
3分後 |
6分後 |
9分後 |
12分後 |
15分後 |
18分後 |
終了時 |
|
Borg
Scale |
0 |
0 |
1 |
1 |
2 |
2 |
3 |
3 |
3 |
3 |
4 |
4 |
5 |
5 |
5 |
5 |
5 |
|
|
|
5 |
|
|
|
f |
|
28 |
22 |
24 |
25 |
24 |
30 |
32 |
49 |
|
49 |
(/min) |
|
|
VT |
|
444 |
597 |
643 |
684 |
804 |
751 |
753 |
668 |
|
|
|
668 |
(ml) |
|
|
VE |
|
12.4 |
12.9 |
15.3 |
16.9 |
19.5 |
22.1 |
23.7 |
31.5 |
|
|
|
31.5 |
(L/min) |
|
|
VO2 |
|
267 |
289 |
423 |
474 |
559 |
654 |
680 |
783 |
|
|
|
783 |
(ml/min) |
|
|
VO2/W |
6.4 |
6.9 |
10.1 |
11.3 |
13.3 |
15.6 |
16.2 |
18.6 |
|
|
|
18.6 |
|
|
|
VCO2 |
|
233 |
272 |
365 |
436 |
553 |
671 |
706 |
880 |
|
|
|
880 |
(ml/min) |
|
|
R |
|
0.87 |
0.94 |
0.86 |
0.92 |
0.99 |
1.03 |
1.04 |
1.12 |
|
|
|
1.12 |
|
|
|
VE/VO2 |
46 |
45 |
36 |
36 |
35 |
34 |
35 |
40 |
|
|
|
40 |
|
|
|
VE/VCO2 |
53 |
47 |
42 |
39 |
35 |
33 |
34 |
36 |
|
|
|
36 |
|
|
|
VD/VT |
0.33 |
0.37 |
0.34 |
0.32 |
0.30 |
0.26 |
0.24 |
0.22 |
|
|
|
0.22 |
|
|
|
HR |
|
83 |
84 |
96 |
101 |
108 |
111 |
111 |
115 |
|
|
|
115 |
(/min) |
|
|
VO2/HR |
3.2 |
3.4 |
4.4 |
4.7 |
5.2 |
5.9 |
6.1 |
6.8 |
|
|
|
6.8 |
|
|
|
METS |
1.8 |
2.0 |
2.9 |
3.2 |
3.8 |
4.4 |
4.6 |
5.3 |
|
|
|
5.3 |
|
|
|
BP |
|
126/78 |
126/78 |
138/76 |
138/79 |
164/90 |
164/84 |
168/79 |
164/80 |
|
|
|
170/80 |
(mmHg) |
|
|
|
|
1.0km/h
17m |
|
50m |
1.6km/h
130m |
|
1.6km/h
210m |
|
2.1km/h
315m |
|
2.7km/h
450m |
|
3.5km/h
625m |
|
|
|
|
|
0% |
|
0% |
|
10% |
|
10% |
|
10% |
|
12% |
|
|
|
|
|
[血液ガス検査] |
|
|
|
|
|
|
|
安静時 |
立位時 |
1分後 |
3分後 |
6分後 |
9分後 |
12分後 |
15分後 |
18分後 |
終了時 |
|
|
pH |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PaO2 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(mmHg) |
|
|
PaCO2 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(mmHg) |
|
|
HCO3 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(mm/L) |
|
|
BE |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(mm/L) |
|
|
SAT |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(%) |
|
|
SpO2 |
|
96 |
96 |
96 |
93 |
93 |
91 |
|
89 |
|
|
86 |
|
|
|
|
86 |
(%) |
|
|
Lactate |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(mg/dl) |
|
|
NA |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(ng/ml) |
|
|
Ad |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(ng/ml) |
|
|
|
|
|
[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 |
|
|
|
|
2. |
peak VO2は予測値(946ml/min)の 82.7%であり、運動能は 軽度低下 を示唆する。 |
|
|
|
|
3. |
運動中の換気当量(VE/VO2)は 健常よりやや大 であり、換気効率は 軽度低下 |
|
|
|
|
|
VEmax/MVV=100% 換気パターンは
slow pattern |
|
VEmax/VEpred=125.0%(VEpred 25.2 l/min) |
|
|
|
|
4. |
最大運動時のPaO2は
− mmHgであり、低酸素血症(PaO2<60mmHg)は − 。 |
|
predmaxVO2 は 913ml/min(Jones) |
|
|
|
|
|
PaO2slope=− |
|
PaCO2slope=− mmHg/100mlVO2 |
|
|
|
|
5. |
運動に伴い、HRは 正常に増加 、O2pulse(VO2/HR)は
正常
であり、心機能は 正常
を示唆する。 |
|
|
|
|
|
HRmax/THR=78.2% |
|
|
|
|
6. |
AT(V-slope)= − ml/min |
|
AT(Lactate)= − ml/min |
|
NT= − ml/min |
|
|
|
|
7. |
運動制限因子は 換気 |
|
|
|
|
|
|
|
|
|
|
|
|
<症例67-後> |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|