【摘要】 目的评价吸入异丙托溴胺是否改善慢性阻塞性肺疾病（COPD）患者的静态肺功能,运动肺功能和运动耐量。方法 2004年11月至2005年3月对中山大学附属第二医院的12例随机抽取稳定期 COPD 患者,吸入异丙托溴胺溶液2 mg,吸入前后分别进行静态肺功能和运动肺功能测定。结果吸入异丙托溴胺后,COPD 患者静态肺功能无明显改变,最大运动功率（Wmax）、最大耗氧量（VO₂max）、最大运动时每分钟通气量（VEmax）和比潮气量（VTmax/IC）,较吸入前均有显著增加;死腔通气（VD/VT）和二氧化碳通气当量（VEmax/VCO₂max）无明显改变。VTmax/IC 的增加（VTmax/IC）与 VO₂max 的增加（VO₂max）有显著相关性（r=0.598,P<0.05）;VTmax/IC 与最大运动功率的增加（Wmax）也存在显著相关性（r=0.743,P<0.05）。结论吸入异丙托溴胺对 COPD 患者的静态通气功能无明显影响,但能够增加患者的运动耐量。比潮气量的增加可能是异丙托溴胺增加运动耐量的机制中的一个重要环节。更多还原

【Abstract】 Objective To evaluate the effect of inhaling Ipratropium bromide to patients with chronic obstructive pulmo- nary disease（COPD）on resting pulmonary function,ventilation and exercise capacity during exercise.Methods All 12 stable patients were diagnosed as COPD.Before and after inhaling single-dose lpratropium bromideis,resting pul- monary function and Symptom-limited progressive cycle ergometer exercise tests were proceed.Results No obvious change in resting pulmouary function after inhaling Ipratropium bromide solution of four times the standard dose,but the maximal rate of work,maximal oxygen uptake,the maximal volume of ventilation per minute and the maximal ratio of tidal volume to inspiratory capacity increase significantly.The maximal dead space/tidal volume ratio and the maximal ventilatory equivalent for CO₂ have no change.There is a significant correlation between the amount of the maximal ratio of tidal volume to inspiratory capacity improved and amount of maximal oxygen uptake improved（r=0.598,P< 0.05）.Another significant correlation exit between the amount of maximal rate of work improved and amount of the maxi- mal ratio of tidal volume to inspiratory capacity improved（r=0.743,P<0.05）.Conclusion Inhaling single-dose Ipratropium brumideis have no effect on spirometry of patient with COPD,will be helpful in improving exercise tolerance of patient.The improvement of maximal ratio of tidal volume to inspiratory capacity could be an important factor about in- haling Ipratropium bromide how to improve exercise tolerance of patient.更多还原