[Blood gas changes during treadmill exercise in convalescents from pulmonary tuberculosis. 2. Clinical results].
We reported earlier in the 1st report the use of treadmill walk apparatus and transcutaneous blood gas measurement apparatus as a newly designed exercise test. In this report, test was carried out in 90 persons (4 healthy, 66 recovered from pulmonary tuberculosis, 3 recovered from silico-pulmonary tuberculosis, 12 of COPD, and 5 of pulmonary fibrosis et bronchiectasis). The changing curves of transcutaneously measured O2 partial pressure (tPo2) were, as previously reported, classified into 4 types: 1. unchange-6, 2. slightly decreased-38, 3. moderately decreased-24, 4. markedly decreased-21. And unexpected odd curves were seen in 4 patients, 3 of whom were retested the other day, and their changing curves of tPo2 in the second test were corrected and classified into slightly or moderately decreased type. The decreasing slopes of 4 types of tPo2 curves were subclassified, in each type, into 3 to 4 forms. In recovered pulmonary tuberculosis patients, in general, when the spread of pathologic changes in the lungs was wider, the more decreased types of tPo2 curves were seen. But in COPD patients, such was not the case. In the exercise test, total tolerance time (minutes) against the definite load was significantly shorter in the more decreased type; unchanged-13.5-14.5, slightly decreased -7-10, moderately decreased-6-9, and markedly decreased-3-5. The recovering time of tPo2, pulse rate, blood pressure etc. from the records in the end of the exercise to the pre-exercise records, was longer in the more decreased type. On the other hand, usually the lower Pao2 of the patients were, the more their changing curves of tPo2 decreased. Pao2 was previously measured in blood taken from brachial artery in supine position before the test. But exceptionally in some patients with high Pao2 value, the curves belonged to markedly decreased type. The changes of oxygen values of some patients during exercise test were individually different, showing that this exercise test reflected their comprehensive respiratory function. Prognosis was especially bad in patients with markedly decreased type, 8 of whom had died from respiratory failure within 2 years after the test. In conclusion, it can be said that this exercise test was effective in judging the pulmonary reserve function and the prognosis in recovered pulmonary tuberculosis patients, but more detailed investigations are necessary, especially in more COPD patients, for the understanding of the respiratory distress.(ABSTRACT TRUNCATED AT 400 WORDS)
Saitama Prefectural Ohara Tuberculosis Sanatorium, Japan.
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Yoshida
D000328:Adult; D000368:Aged; D001785:Blood Gas Monitoring, Transcutaneous; D003289:Convalescence; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014397:Tuberculosis, Pulmonary / Q000097:blood*