만성 폐쇄성 폐질환(COPD) 환자에서 운동 시 발생하는 산소 불포화 반응과 관련된 인자

Other Titles
Factors Related to Exertional Oxygen Desaturation in Patients with COPD
Authors
심상우조준연권용식채진녕박지혜이미영노병학최원일
Department
Dept. of Preventive Medicine (예방의학); Dept. of Radiology (영상의학); Dept. of Internal Medicine (내과학)
Issue Date
2011
Citation
결핵 및 호흡기 질환, Vol.70(6) : 498-503, 2011
ISSN
1738-3536
Abstract
Background: The causes of exertional desaturation in patients with COPD can be multifactorial. We aimed to investigate factors predict exertional desaturation in patients with moderate to severe COPD. Methods: We tested 51 consecutive patients with stable COPD (FEV1/FVC, 40±13% predicted). Patients performed a six minute walk test (6MWT). Pulse oxymetric saturation (SpO2) and pulse rate were recorded. Results: Oxygen desaturation was found in 15 subjects after 6MWT, while 36 subjects were not desaturated. Lung diffusing capacity was significantly lower in desaturation (DS) group (62±18% predicted) compared with not desaturated (ND) group (84±20, p<0.01). However there was no statistical difference of FEV1/FVC ratio or residual volume between two groups. The pulse rate change was significantly higher in the desaturated compared with the not desaturated group. Six minute walking distance, subjective dyspnea scale, airflow obstruction, and residual volume did not predict exertional oxygen desaturation. Independent factors assessed by multiple logistic regression revealed that a pulse rate increment (odd ratio [OR], 1.19; 95% confidence interval [CI], 1.01∼1.40; p=0.02), a decrease in baseline PaO2 (OR, 1.105; 95% CI, 1.003∼1.218; p=0.04) and a decrease in lung diffusing capacity (OR, 1.10; 95% CI, 1.01∼1.19; p=0.01) were significantly associated with oxygen desaturation. Receiver operator characteristic (ROC) analysis showed that an absolute increment in pulse rate of 16/min gave optimal discrimination between desaturated and not desaturated patients after 6MWT. Conclusion: Pulse rate increment and diffusion capacity can predict exertional oxygen desaturation in stable COPD patients with moderate to severe airflow obstruction. Key Words: Pulmonary Disease, Chronic Obstructive; Heart Rate; Anoxia
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/37343
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
이미영; 노병학; 최원일
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