|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
無断転載禁止 |
運動負荷心肺機能検査 |
|
|
|
|
[肺機能検査] |
|
|
|
|
|
VC |
1.9 |
(L) |
CV |
|
(%) |
|
MVV: |
19.6 |
|
|
|
|
%VC |
57.6 |
(%) |
dN2 |
0.01 |
(%) |
|
THR: |
154 |
|
|
|
FVC |
1.7 |
(L) |
TLC |
4.61 |
(L) |
|
|
%FVC |
51.6 |
(%) |
RV/TLC |
58.9 |
(%) |
|
|
FEV1.0 |
0.56 |
(L) |
DLCO |
6.35 |
|
|
|
%FEV1 |
19.8 |
(%) |
%DLCO |
40.1 |
(%) |
|
|
FEV1.0% |
32.9 |
(%) |
DLCO/VA |
1.582 |
|
|
|
FEV1/VCp |
17.0 |
(%) |
Vtg |
|
|
|
|
IC |
1.15 |
(%) |
FRC |
3.46 |
|
|
|
|
|
【O2(-)(21%)】 |
|
|
[心肺機能検査] |
|
|
protocol: |
Ergo 漸増 |
|
Watt |
|
運動時間: |
4分31秒 |
中止理由: |
下肢疲労 |
|
|
|
|
|
|
|
|
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 |
|
|
|
|
|
|
|
|
|
|
|
30 |
|
Borg
Scale |
0 |
0 |
0 |
1 |
3 |
|
|
|
|
|
|
|
|
|
|
|
|
4 |
|
|
|
f |
|
18 |
14 |
22 |
|
|
|
|
|
|
26 |
(/min) |
|
|
VT |
|
688 |
1108 |
948 |
|
|
|
|
|
|
832 |
(ml) |
|
|
VE |
|
11.9 |
15.5 |
20.4 |
|
|
|
|
|
|
21.8 |
(L/min) |
|
|
VO2 |
|
209 |
394 |
492 |
|
|
|
|
|
|
519 |
(ml/min) |
|
|
VO2/W |
5.4 |
10.1 |
12.6 |
|
|
|
|
|
|
13.3 |
|
|
|
VCO2 |
|
202 |
378 |
508 |
|
|
|
|
|
|
528 |
(ml/min) |
|
|
R |
|
0.97 |
0.96 |
1.03 |
|
|
|
|
|
|
1.02 |
|
|
|
VE/VO2 |
57 |
39 |
42 |
|
|
|
|
|
|
42 |
|
|
|
VE/VCO2 |
59 |
41 |
40 |
|
|
|
|
|
|
41 |
|
|
|
VD/VT |
0.42 |
0.38 |
0.97 |
|
|
|
|
|
|
0.37 |
|
|
|
HR |
|
97 |
105 |
114 |
|
|
|
|
|
|
117 |
(/min) |
|
|
VO2/HR |
2.2 |
3.8 |
4.3 |
|
|
|
|
|
|
4.4 |
|
|
|
METS |
1.2 |
2.4 |
2.9 |
|
|
|
|
|
|
2.9 |
|
|
|
BP |
|
133/81 |
153/86 |
154/86 |
|
|
|
|
|
|
154/86 |
(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 |
|
7.395 |
7.386 |
7.366 |
|
|
|
|
|
|
|
|
|
7.366 |
|
|
PaO2 |
|
67.5 |
65.2 |
63.3 |
|
|
|
|
|
|
|
|
|
63.3 |
(mmHg) |
|
|
PaCO2 |
47.2 |
49.0 |
50.4 |
|
|
|
|
|
|
|
|
|
50.4 |
(mmHg) |
|
|
HCO3 |
|
28.3 |
28.7 |
28.1 |
|
|
|
|
|
|
|
|
|
28.1 |
(mm/L) |
|
|
BE |
|
3.1 |
3.3 |
2.3 |
|
|
|
|
|
|
|
|
|
2.3 |
(mm/L) |
|
|
SAT |
|
95.0 |
96.9 |
93.3 |
|
|
|
|
|
|
|
|
|
93.3 |
(%) |
|
|
SpO2 |
|
94 |
94 |
93 |
|
|
|
|
|
|
|
|
|
92 |
(%) |
|
|
Lactate |
0.9 |
1.4 |
2.2 |
|
|
|
|
|
|
|
|
|
2.2 |
(mg/dl) |
|
|
NA |
|
1.420 |
1.580 |
1.930 |
|
|
|
|
|
|
|
|
|
1.930 |
(ng/ml) |
|
|
Ad |
|
0.309 |
0.410 |
0.580 |
|
|
|
|
|
|
|
|
|
0.580 |
(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(1137ml/min)の 45.7 %であり、運動能は 低下 を示唆する。 |
|
|
|
|
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 |
|
|
|
|
|
VEmax/MVV=111.2% 換気パターンは
shallow |
|
VEmax/VEpred= ? %(VEpred 0.0 l/min) |
|
|
|
|
4. |
最大運動時のPaO2は63.3mmHgであり、低酸素血症(PaO2<60mmHg)は呈さない。 |
|
|
|
|
|
PaO2slope=-1.35 |
|
PaCO2slope=1.03mmHg/100mlVO2 |
|
|
|
|
5. |
運動に伴い、HRは 健常より大 、O2pulse(VO2/HR)は 評価不能 であり、心機能は を示唆する。 |
|
|
|
|
|
HRmax/THR=76.0% |
|
|
|
|
6. |
AT(V-slope)= 382 ml/min |
|
AT(Lactate)= 評価不能 ml/min |
|
NT= − ml/min |
|
|
|
|
7. |
運動制限因子は 換気 |
|
|
|
|
|
|
|
|
|
|
|
|
<症例72-前> |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|