|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
無断転載禁止 |
運動負荷心肺機能検査 |
|
|
|
|
[肺機能検査] |
|
|
|
|
|
|
VC |
1.39 |
(L) |
CV |
0.11 |
(%) |
|
MVV: |
39.2 |
|
|
|
|
%VC |
55.6 |
(%) |
dN2 |
|
(%) |
|
THR: |
153 |
|
|
FVC |
1.35 |
(L) |
TLC |
2.46 |
(L) |
|
|
%FVC |
54.0 |
(%) |
RV/TLC |
43.5 |
(%) |
|
|
FEV1.0 |
1.12 |
(L) |
DLCO |
7.55 |
|
|
|
|
%FEV1 |
53.4 |
(%) |
%DLCO |
46.0 |
(%) |
|
|
FEV1.0% |
83.0 |
(%) |
DLCO/VA |
4.011 |
|
|
|
|
FEV1/VCp |
44.8 |
(%) |
Vtg |
|
|
|
|
|
IC |
0.93 |
(%) |
FRC |
|
|
|
|
|
|
|
【O2(-)(21%)】 |
|
|
[心肺機能検査] |
|
|
protocol: |
m-Toneyama |
|
Watt |
運動時間: |
7分45秒 |
中止理由: |
息切れ |
|
|
|
|
|
|
|
|
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 |
|
|
Watt |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Borg
Scale |
0 |
0 |
0.5 |
3 |
4 |
5 |
5 |
|
|
|
|
|
|
|
|
|
|
|
|
|
5 |
|
|
|
f |
|
37 |
36 |
35 |
41 |
46 |
|
|
|
|
51 |
(/min) |
|
|
VT |
|
401 |
496 |
588 |
586 |
660 |
|
|
|
|
617 |
(ml) |
|
|
VE |
|
14.7 |
17.8 |
20.4 |
22.8 |
30.1 |
|
|
|
|
31.0 |
(L/min) |
|
|
VO2 |
|
265 |
337 |
479 |
525 |
662 |
|
|
|
|
701 |
(ml/min) |
|
|
VO2/W |
5.4 |
6.9 |
9.8 |
10.7 |
13.5 |
|
|
|
|
14.3 |
|
|
|
VCO2 |
|
244 |
310 |
410 |
493 |
666 |
|
|
|
|
710 |
(ml/min) |
|
|
R |
|
0.92 |
0.92 |
0.86 |
0.94 |
1.01 |
|
|
|
|
1.01 |
|
|
|
VE/VO2 |
55 |
53 |
43 |
43 |
45 |
|
|
|
|
44 |
|
|
|
VE/VCO2 |
60 |
57 |
50 |
46 |
45 |
|
|
|
|
44 |
|
|
|
VD/VT |
0.35 |
0.36 |
0.35 |
0.32 |
0.34 |
|
|
|
|
0.33 |
|
|
|
HR |
|
105 |
114 |
117 |
121 |
131 |
|
|
|
|
134 |
(/min) |
|
|
VO2/HR |
2.5 |
3.0 |
4.1 |
4.3 |
5.1 |
|
|
|
|
5.2 |
|
|
|
METS |
1.5 |
2.0 |
2.8 |
3.1 |
3.9 |
|
|
|
|
3.8 |
|
|
|
BP |
|
156/89 |
154/93 |
154/93 |
157/94 |
161/96 |
|
|
|
|
161/96 |
(mmHg) |
|
|
|
|
|
1.0q/h |
17m |
|
50m |
1.6q/h |
130m |
1.6q/h |
210m |
2.1q/h |
315m |
2.7q/h |
450m |
3.5q/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 |
|
7.411 |
|
7.416 |
7.405 |
7.381 |
|
|
|
|
|
|
|
|
|
|
7.391 |
|
|
PaO2 |
|
92.6 |
86.4 |
81.3 |
77.2 |
|
|
|
|
|
|
|
|
|
|
76.7 |
(mmHg) |
|
|
PaCO2 |
40.4 |
39.6 |
40.7 |
42.6 |
|
|
|
|
|
|
|
|
|
|
39.8 |
(mmHg) |
|
|
HCO3 |
|
25.2 |
25.0 |
25.0 |
24.6 |
|
|
|
|
|
|
|
|
|
|
23.7 |
(mm/L) |
|
|
BE |
|
1.0 |
1.0 |
0.8 |
-0.1 |
|
|
|
|
|
|
|
|
|
|
-0.6 |
(mm/L) |
|
|
SAT |
|
98.2 |
97.4 |
97.0 |
95.9 |
|
|
|
|
|
|
|
|
|
|
96.2 |
(%) |
|
|
SpO2 |
|
98 |
98 |
98 |
99 |
99 |
|
|
|
|
|
|
|
|
|
|
97 |
(%) |
|
|
Lactate |
0.8 |
|
0.9 |
1.2 |
1.6 |
|
|
|
|
|
|
|
|
|
|
1.9 |
(mg/dl) |
|
|
NA |
|
1.160 |
1.506 |
1.799 |
2.109 |
|
|
|
|
|
|
|
|
|
|
2.521 |
(ng/ml) |
|
|
Ad |
|
0.268 |
0.290 |
0.453 |
0.316 |
|
|
|
|
|
|
|
|
|
|
0.348 |
(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(1267ml/min)の 55.3 %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 健常よりやや大 であり、換気効率は やや低下 |
|
|
|
|
|
VEmax/MVV=79.1% 換気パターンは
rapid and shallow pattern |
|
VEmax/VEpred= ? %(VEpred 0.0 l/min) |
|
|
|
|
4. |
最大運動時のPaO2は76.7mmHgであり、低酸素血症(PaO2<60mmHg)は呈さない。 |
pred max VO2 1497 ml/min |
|
|
|
|
|
PaO2slope= -3.65 |
|
PaCO2slope=-0.14mmHg/100mlVO2 |
|
(Jones) |
|
|
|
|
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=87.6% |
|
|
|
|
6. |
AT(V-slope)= 550 ml/min |
|
AT(Lactate)= 580.0 ml/min |
|
NT= − ml/min |
|
|
|
|
7. |
運動制限因子は 換気、下肢疲労 |
|
|
|
|
|
|
|
|
|
|
|
|
<症例75-前> |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|