|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
無断転載禁止 |
|
|
運動負荷心肺機能検査 |
|
|
|
|
|
[肺機能検査] |
|
|
|
|
|
|
|
VC |
3.11 |
(L) |
CV |
(%) |
|
|
MVV: |
|
33.25 |
|
|
|
|
%VC |
100.4 |
(%) |
dN2 |
(%) |
|
|
THR: |
|
147 |
|
|
FVC |
2.77 |
(L) |
TLC |
(L) |
|
|
|
%FVC |
89.4 |
(%) |
RV/TLC |
(%) |
|
|
|
FEV1.0 |
0.95 |
(L) |
DLCO |
|
|
|
|
%FEV1 |
38.2 |
(%) |
%DLCO |
(%) |
|
|
|
FEV1.0% |
34.3 |
(%) |
DLCO/VA |
|
|
|
FEV1/VCp |
30.7 |
(%) |
Vtg |
|
|
|
IC |
|
(%) |
FRC |
|
|
|
|
|
|
|
|
[心肺機能検査] |
|
|
protocol: |
m-Toneyama |
|
Watt |
|
運動時間: |
11分24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 |
|
Borg
Scale |
0 |
0 |
0 |
0 |
0.5 |
1 |
1 |
2 |
3 |
3 |
4 |
5 |
|
|
|
|
|
|
7 |
|
|
|
RR |
|
15 |
12 |
15 |
19 |
17 |
19 |
|
|
|
23 |
(/min) |
|
|
VT |
|
969 |
723 |
1024 |
1082 |
1123 |
1409 |
|
|
|
1429 |
(ml) |
|
|
VE |
|
9.3 |
10.0 |
15.1 |
19.4 |
18.7 |
27.0 |
|
|
|
31.8 |
(L/min) |
|
|
VO2 |
|
183 |
207 |
359 |
471 |
452 |
740 |
|
|
|
912 |
(ml/min) |
|
|
VO2/W |
3.2 |
3.6 |
6.2 |
8.1 |
7.8 |
12.8 |
|
|
|
15.7 |
|
|
|
VCO2 |
|
171 |
194 |
307 |
396 |
413 |
675 |
|
|
|
880 |
(ml/min) |
|
|
R |
|
0.93 |
0.94 |
0.86 |
0.84 |
0.91 |
0.91 |
|
|
|
0.96 |
|
|
|
VE/VO2 |
51 |
48 |
42 |
4 |
41 |
36 |
|
|
|
35 |
|
|
|
VE/VCO2 |
54 |
52 |
49 |
49 |
45 |
40 |
|
|
|
36 |
|
|
|
VD/VT |
0.40 |
0.33 |
0.42 |
0.42 |
0.40 |
0.37 |
|
|
|
0.35 |
|
|
|
HR |
|
88 |
91 |
93 |
98 |
104 |
116 |
|
|
|
127 |
(/min) |
|
|
VO2/HR |
2.1 |
2.3 |
3.9 |
4.8 |
4.4 |
6.4 |
|
|
|
7.2 |
|
|
|
METS |
0.9 |
1.0 |
1.8 |
2.3 |
2.2 |
3.6 |
|
|
|
4.5 |
|
|
|
BP |
|
141/57 |
|
126/59 |
151/65 |
158/62 |
181/66 |
|
|
|
201/72 |
(mmHg) |
|
|
|
|
[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 |
|
7.438 |
|
7.427 |
7.412 |
7.402 |
7.387 |
|
|
|
|
|
|
|
7.359 |
|
|
PaO2 |
|
76.3 |
67.2 |
62.4 |
63.5 |
59.4 |
|
|
|
|
|
|
|
58.1 |
(mmHg) |
|
|
PaCO2 |
39.6 |
41.7 |
42.6 |
44.5 |
45.7 |
|
|
|
|
|
|
|
47.7 |
(mmHg) |
|
|
HCO3 |
|
26.4 |
27.0 |
26.6 |
27.1 |
26.9 |
|
|
|
|
|
|
|
26.2 |
(mm/L) |
|
|
BE |
|
2.5 |
2.8 |
2.3 |
2.5 |
2.0 |
|
|
|
|
|
|
|
0.9 |
(mm/L) |
|
|
SAT |
|
99.1 |
96.8 |
96.9 |
96.4 |
93.2 |
|
|
|
|
|
|
|
94.0 |
(%) |
|
|
SpO2 |
|
99 |
97 |
95 |
91 |
92 |
89 |
|
|
|
|
|
|
|
88 |
(%) |
|
|
Lactate |
0.8 |
|
0.9 |
0.9 |
1.0 |
1.5 |
|
|
|
|
|
|
|
2.4 |
(mg/dl) |
|
|
NA |
|
0.594 |
0.731 |
0.82 |
0.97 |
1.59 |
|
|
|
|
|
|
|
2.903 |
(ng/ml) |
|
|
Ad |
|
0.070 |
0.071 |
0.083 |
0.096 |
0.146 |
|
|
|
|
|
|
|
0.227 |
(ng/ml) |
|
|
|
|
|
[コメント] |
|
|
|
1. |
ECG所見 VPB: なし SVPB:
なし その他:
CRBBB |
|
ST変化: なし 心電図判定: 陰性 |
|
|
|
|
2. |
peak VO2は予測値(1421ml/min)の 64.2 %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=95.6% 換気パターンは slow and deep pattern |
|
VEmax/VEpred=108.3%(VEpred 29.4 l/min) |
|
|
|
|
4. |
最大運動時のPaO2は58.1Torrであり、低酸素血症(PaO2<60mmHg)は呈する。 |
|
|
|
|
|
PaO2slope=-2.50 |
|
PaCO2slope=1.11Torr/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 正常 を示唆する。 |
|
|
|
|
|
HRmax/THR=86.4% |
|
|
|
|
6. |
AT(V-slope)= - ml/min |
|
AT(Lactate)= ml/min |
|
NT= ml/min |
|
|
|
|
7. |
運動制限因子は 換気 |
|
|
|
|
その他: |
|
|
|
|
|
|
|
|
|
|
<症例80-後> |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|