心肺运动试验在评估慢性阻塞性肺疾病表型中的应用
Application of Cardiopulmonary Exercise Testing in Evaluating the Phenotype of Chronic Obstructive Pulmonary Disease
DOI: 10.12677/ACM.2024.142412, PDF,   
作者: 刘欣泉*:重庆医科大学,重庆;中国科学院重庆绿色智能技术研究院,重庆;中国科学院大学重庆学院,重庆;重庆市人民医院呼吸与危重症医学科,重庆;姜英松#:重庆医科大学,重庆;中国科学院重庆绿色智能技术研究院,重庆;中国科学院大学重庆学院,重庆;重庆市人民医院肾内科,重庆
关键词: 慢性阻塞性肺疾病心肺运动试验表型运动受限Chronic Obstructive Pulmonary Disease Cardiopulmonary Exercise Testing Phenotype Exercise Limitation
摘要: 慢性阻塞性肺疾病(Chronic obstructive pulmonary disease, COPD)是一种常见的以持续呼吸道症状和气流受限为特征的异质性疾病,COPD在临床症状、影像学表现、治疗反应、生理功能等方面存在着异质性。识别出具有临床意义的表型,对于COPD的病情评估以及个体化治疗至关重要。运动受限和呼吸困难在COPD患者中广泛存在,心肺运动试验可以帮助我们分析COPD患者运动受限的原因、评估心肺健康以及评估疾病预后,本文主要阐述COPD分型的重要性以及近些年心肺运动试验在评估COPD表型中的应用。
Abstract: Chronic obstructive pulmonary disease (COPD) is a common and heterogeneous disease character-ized by persistent respiratory symptoms and airflow limitation, with heterogeneity in clinical symptoms, imaging findings, therapeutic response, and physiological function. The identification of clinically significant phenotypes is essential for the assessment and individualized treatment of COPD. Exercise limitations and dyspnea are widespread in patients with COPD. Cardiopulmonary exercise testing can help us analyze the causes of Exercise limitations in patients with COPD, stratify cardiorespiratory fitness and assess the prognosis of the disease. This article mainly describes the importance of COPD classification and the application of cardiopulmonary exercise testing in evalu-ating COPD phenotype in recent years.
文章引用:刘欣泉, 姜英松. 心肺运动试验在评估慢性阻塞性肺疾病表型中的应用[J]. 临床医学进展, 2024, 14(2): 2910-2915. https://doi.org/10.12677/ACM.2024.142412

参考文献

[1] Corlateanu, A., Mendez, Y., Wang, Y., et al. (2020) Chronic Obstructive Pulmonary Disease and Phenotypes: A State- of-the-Art. Pulmonology, 26, 95-100. [Google Scholar] [CrossRef] [PubMed]
[2] Agusti, A. (2014) The Path to Personalised Medicine in COPD. Thorax, 69, 857-864. [Google Scholar] [CrossRef] [PubMed]
[3] Stolz, D., Mkorombindo, T., Schumann, D.M., et al. (2022) Towards the Elimination of Chronic Obstructive Pulmonary Disease: A Lancet Commission. Lancet, 400, 921-972. [Google Scholar] [CrossRef
[4] Jones, P., Miravitlles, M., Van Der Molen, T., et al. (2012) Beyond FEV1 in COPD: A Review of Patient-Reported Outcomes and Their Measurement. International Journal of Chronic Obstructive Pulmonary Disease, 7, 697-709. [Google Scholar] [CrossRef
[5] Dournes, G., Laurent, F., Coste, F., et al. (2015) Computed Tomo-graphic Measurement of Airway Remodeling and Emphysema in Advanced Chronic Obstructive Pulmonary Disease. Correlation with Pulmonary Hypertension. American Journal of Respiratory and Critical Care Medicine, 191, 63-70. [Google Scholar] [CrossRef
[6] Bui, D.S., Lodge, C.J., Burgess, J.A., et al. (2018) Childhood Predictors of Lung Function Trajectories and Future COPD Risk: A Prospective Cohort Study from the First to the Sixth Decade of Life. The Lancet Respiratory Medicine, 6, 535-544. [Google Scholar] [CrossRef
[7] Karakioulaki, M., Papakonstantinou, E. and Stolz, D. (2020) Extracellular Matrix Remodelling in COPD. European Respiratory Review, 29, Article ID: 190124. [Google Scholar] [CrossRef] [PubMed]
[8] Mkorombindo, T. and Dransfield, M.T. (2022) Pre-Chronic Obstructive Pulmonary Disease: A Pathophysiologic Process or an Opinion Term? Current Opinion in Pulmonary Med-icine, 28, 109-114. [Google Scholar] [CrossRef
[9] Barker, B.L. and Brightling, C.E. (2013) Phenotyping the Heterogeneity of Chronic Obstructive Pulmonary Disease. Clinical Science, 124, 371-387. [Google Scholar] [CrossRef
[10] AgustÍ, A., MelÉN, E., Demeo, D.L., et al. (2022) Pathogenesis of Chronic Obstructive Pulmonary Disease: Understanding the Contributions of Gene-Environment Interactions across the Lifespan. The Lancet Respiratory Medicine, 10, 512-524. [Google Scholar] [CrossRef
[11] Han, M.K., Agusti, A., Calverley, P.M., et al. (2010) Chronic Obstructive Pulmonary Disease Phenotypes: The Future of COPD. American Journal of Respiratory and Criti-cal Care Medicine, 182, 598-604. [Google Scholar] [CrossRef
[12] Lange, P., Halpin, D.M., O’donnell, D.E., et al. (2016) Diag-nosis, Assessment, and Phenotyping of COPD: Beyond FEV1. International Journal of Chronic Obstructive Pulmonary Disease, 11, 3-12. [Google Scholar] [CrossRef
[13] Yousuf, A., Mcauley, H., Elneima, O. and Brightling, C.E. (2021) The Different Phenotypes of COPD. British Medical Bulletin, 137, 82-97. [Google Scholar] [CrossRef] [PubMed]
[14] Chong, J., Leung, B. and Poole, P. (2017) Phosphodiesterase 4 Inhibitors for Chronic Obstructive Pulmonary Disease. Cochrane Database of Systematic Reviews, 9, CD002309. [Google Scholar] [CrossRef
[15] Hancock, D.B., Eijgelsheim, M., Wilk, J.B., et al. (2010) Meta-Analyses of Genome-Wide Association Studies Identify Multiple Loci Associated with Pulmonary Function. Na-ture Genetics, 42, 45-52. [Google Scholar] [CrossRef] [PubMed]
[16] Wen, X., Deng, Z., Peng, J., et al. (2023) Character-istics of Inflammatory Phenotypes in Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study. BMJ Open Respiratory Research, 10, e001454. [Google Scholar] [CrossRef] [PubMed]
[17] Park, J., Hobbs, B.D., Crapo, J.D., et al. (2020) Subtyping COPD by Using Visual and Quantitative CT Imaging Features. Chest, 157, 47-60. [Google Scholar] [CrossRef] [PubMed]
[18] Kim, V. and Criner, G.J. (2013) Chronic Bronchitis and Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, 187, 228-237. [Google Scholar] [CrossRef
[19] Bao, H., Jia, G., Cong, S., et al. (2021) Phenotype and Man-agement of Chronic Obstructive Pulmonary Disease Patients in General Population in China: A Nationally Cross-Sectional Study. NPJ Primary Care Respiratory Medicine, 31, Article No. 32. [Google Scholar] [CrossRef] [PubMed]
[20] Phillips, D.B., Elbehairy, A.F., James, M.D., et al. (2022) Im-paired Ventilatory Efficiency, Dyspnea, and Exercise Intolerance in Chronic Obstructive Pulmonary Disease: Results from the CanCOLD Study. American Journal of Respiratory and Critical Care Medicine, 205, 1391-1402. [Google Scholar] [CrossRef
[21] Boutou, A.K., Zafeiridis, A., Pitsiou, G., et al. (2020) Cardio-pulmonary Exercise Testing in Chronic Obstructive Pulmonary Disease: An Update on Its Clinical Value and Applica-tions. Clinical Physiology and Functional Imaging, 40, 197-206. [Google Scholar] [CrossRef] [PubMed]
[22] James, M.D., Milne, K.M., Phillips, D.B., et al. (2020) Dyspnea and Exercise Limitation in Mild COPD: The Value of CPET. Frontiers in Medicine, 7, Article 442. [Google Scholar] [CrossRef] [PubMed]
[23] Broxterman, R.M., Hoff, J., Wagner, P.D., et al. (2020) Determinants of the Diminished Exercise Capacity in Patients with Chronic Obstructive Pul-monary Disease: Looking Beyond the Lungs. The Journal of Physiology, 598, 599-610. [Google Scholar] [CrossRef
[24] Maltais, F., Leblanc, P., Whittom, F., et al. (2000) Oxidative Enzyme Activ-ities of the Vastus Lateralis Muscle and the Functional Status in Patients with COPD. Thorax, 55, 848-853. [Google Scholar] [CrossRef] [PubMed]
[25] Stickland, M.K., Neder, J.A., Guenette, J.A., et al. (2022) Using Cardiopulmonary Exercise Testing to Understand Dyspnea and Exercise Intolerance in Respiratory Disease. Chest, 161, 1505-1516. [Google Scholar] [CrossRef] [PubMed]
[26] Glaab, T. and Taube, C. (2022) Practical Guide to Cardiopulmo-nary Exercise Testing in Adults. Respiratory Research, 23, Article No. 9. [Google Scholar] [CrossRef] [PubMed]
[27] 中华医学会心血管病学分会, 中国康复医学会心肺预防与康复专业委员会, 中华心血管病杂志编辑委员会. 心肺运动试验临床规范应用中国专家共识[J]. 中华心血管病杂志, 2022, 50(10): 973-986.
[28] Palange, P., Ward, S.A., Carlsen, K.H., et al. (2007) Recommendations on the Use of Exercise Testing in Clinical Practice. European Respiratory Journal, 29, 185-209. [Google Scholar] [CrossRef] [PubMed]
[29] Gelinas, J., Harper, M., Sasso, J., et al. (2022) Phenotyping Car-diopulmonary Exercise Limitations in Chronic Obstructive Pulmonary Disease. Frontiers in Physiology, 13, Article 816586. [Google Scholar] [CrossRef] [PubMed]
[30] Weber, K.T. and Janicki, J.S. (1985) Cardiopulmonary Exercise Testing for Evaluation of Chronic Cardiac Failure. Am The American Journal of Cardiology, 55, 22A-31A. [Google Scholar] [CrossRef] [PubMed]
[31] Caruso, F.R., Goulart, C.D.L., Bonjorno Jr., J.C., et al. (2023) Predictors of Cardiopulmonary Exercise Testing in COPD Patients according to the Weber Classification. Heart & Lung, 62, 95-100. [Google Scholar] [CrossRef] [PubMed]