|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
無断転載禁止 |
運動負荷心肺機能検査 |
|
|
|
|
[肺機能検査] |
|
|
|
|
|
VC |
1.12 |
(L) |
CV |
0.10 |
(%) |
|
MVV: |
36.4 |
|
|
|
|
%VC |
51.1 |
(%) |
dN2 |
|
(%) |
|
THR: |
149 |
|
|
|
FVC |
1.10 |
(L) |
TLC |
2.24 |
(L) |
|
|
%FVC |
50.2 |
(%) |
RV/TLC |
50.1 |
(%) |
|
|
FEV1.0 |
1.04 |
(L) |
DLCO |
8.15 |
|
|
|
%FEV1 |
56.9 |
(%) |
%DLCO |
79.4 |
(%) |
|
|
FEV1.0% |
94.5 |
(%) |
DLCO/VA |
4.613 |
|
|
|
FEV1/VCp |
47.5 |
(%) |
Vtg |
|
|
|
|
IC |
0.74 |
(%) |
FRC |
|
|
|
|
|
|
【O2(-)(21%)】 |
|
|
[心肺機能検査] |
|
|
protocol: |
Ergo 漸増 |
10 |
Watt |
|
運動時間: |
6分29秒 |
中止理由: |
下肢疲労,THR |
|
|
|
|
|
|
|
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 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Borg
Scale |
0 |
1 |
2 |
3 |
3 |
3 |
4 |
|
|
|
|
|
|
|
|
|
|
5 |
|
|
|
f |
|
35 |
33 |
37 |
43 |
|
|
|
|
|
43 |
(/min) |
|
|
VT |
|
295 |
543 |
567 |
593 |
|
|
|
|
|
593 |
(ml) |
|
|
VE |
|
10.2 |
17.6 |
21.1 |
25.8 |
|
|
|
|
|
25.8 |
(L/min) |
|
|
VO2 |
|
199 |
524 |
587 |
749 |
|
|
|
|
|
749 |
(ml/min) |
|
|
VO2/W |
6.4 |
16.9 |
18.9 |
24.2 |
|
|
|
|
|
24.2 |
|
|
|
VCO2 |
|
213 |
537 |
683 |
873 |
|
|
|
|
|
873 |
(ml/min) |
|
|
R |
|
1.07 |
1.02 |
1.16 |
1.17 |
|
|
|
|
|
1.17 |
|
|
|
VE/VO2 |
51 |
34 |
36 |
34 |
|
|
|
|
|
34 |
|
|
|
VE/VCO2 |
48 |
33 |
31 |
30 |
|
|
|
|
|
30 |
|
|
|
VD/VT |
0.26 |
0.27 |
0.26 |
0.26 |
|
|
|
|
|
0.26 |
|
|
|
HR |
|
100 |
124 |
135 |
145 |
|
|
|
|
|
145 |
(/min) |
|
|
VO2/HR |
2.0 |
4.2 |
4.3 |
5.2 |
|
|
|
|
|
5.2 |
|
|
|
METS |
1.8 |
4.8 |
5.4 |
6.2 |
|
|
|
|
|
6.2 |
|
|
|
BP |
|
124/67 |
|
157/80 |
163/79 |
|
|
|
|
|
|
(mmHg) |
|
|
|
|
[血液ガス検査] |
|
|
|
|
|
|
|
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 |
|
7.393 |
7.359 |
7.338 |
7.305 |
|
|
|
|
|
|
|
|
7.317 |
|
|
PaO2 |
|
95.7 |
74.2 |
79.5 |
75.3 |
|
|
|
|
|
|
|
|
79.7 |
(mmHg) |
|
|
PaCO2 |
43.9 |
48.5 |
52.2 |
54.0 |
|
|
|
|
|
|
|
|
52.2 |
(mmHg) |
|
|
HCO3 |
|
26.2 |
26.7 |
27.3 |
26.1 |
|
|
|
|
|
|
|
|
25.9 |
(mm/L) |
|
|
BE |
|
1.5 |
1.3 |
1.3 |
-0.4 |
|
|
|
|
|
|
|
|
-0.3 |
(mm/L) |
|
|
SAT |
|
97.7 |
94.6 |
95.1 |
93.7 |
|
|
|
|
|
|
|
|
95.0 |
(%) |
|
|
SpO2 |
|
96 |
93 |
94 |
93 |
|
|
|
|
|
|
|
|
93 |
(%) |
|
|
Lactate |
1.1 |
1.6 |
2.6 |
4.0 |
|
|
|
|
|
|
|
|
4.4 |
(mg/dl) |
|
|
NA |
|
0.758 |
1.635 |
2.278 |
4.275 |
|
|
|
|
|
|
|
|
4.373 |
(ng/ml) |
|
|
Ad |
|
0.355 |
0.516 |
0.628 |
1.553 |
|
|
|
|
|
|
|
|
1.693 |
(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(767ml/min)の 97.6 %であり、運動能は を示唆する。 |
|
|
|
|
3. |
運動中の換気当量(VE/VO2)は 正常に増加 であり、換気効率は 正常 |
|
|
|
|
|
VEmax/MVV=70.9% 換気パターンは
rapid and shallow pattern |
|
VEmax/VEpred=103.3%(VEpred 25.0 l/min) |
|
|
|
|
4. |
最大運動時のPaO2は79.7mmHgであり、低酸素血症(PaO2<60mmHg)は呈さない。 |
|
|
|
|
|
PaO2slope=-2.91 |
|
PaCO2slope=1.51mmHg/100mlVO2 |
|
|
|
|
5. |
運動に伴い、HRは 健常より大 、O2pulse(VO2/HR)は 頭打ちにはならず であり、心機能は 低下 を示唆する。 |
|
|
|
|
|
HRmax/THR=97.3% |
|
|
|
|
6. |
AT(V-slope)= 575 ml/min |
|
AT(Lactate)= 530.0 ml/min |
|
NT= − ml/min |
|
|
|
|
7. |
運動制限因子は 換気、心機能、下肢疲労 |
|
|
|
|
|
|
|
|
|
|
|
|
<症例71-前> |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|