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

• Published in: Tuberculosis and respiratory diseases Vol. 70; no. 6; pp. 498 - 503
• Main Authors: 심상우, Sang Woo Shim, 조준연, Jun Yeon Jo, 권용식, Yong Sik Kwon, 채진녕, Jin Nyeong Chae, 박지혜, Jie Hae Park, 이미영, Mi Young Lee, 노병학, Byung Hak Rho, 최원일, Won Il Choi
• Format: Journal Article
• Language: Korean
• Published: 대한결핵 및 호흡기학회 30.06.2011; 대한결핵및호흡기학회
• Subjects: Anoxia; Chronic Obstructive; Heart Rate; Pulmonary Disease; 내과학; Pulmonary Disease; Heart Rate; Chronic Obstructive; Anoxia
• ISSN: 1738-3536; 2005-6184

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.