請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/41573
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 王儷穎(Li-Ying Wang) | |
dc.contributor.author | Wen-Yu Chen | en |
dc.contributor.author | 陳文郁 | zh_TW |
dc.date.accessioned | 2021-06-15T00:23:31Z | - |
dc.date.available | 2010-02-17 | |
dc.date.copyright | 2009-02-17 | |
dc.date.issued | 2009 | |
dc.date.submitted | 2009-02-01 | |
dc.identifier.citation | 1. Gaspard UJ, Gottal JM, van den Brule FA. Postmenopausal changes of lipid and glucose metabolism: a review of their main aspects. Maturitas 1995;21:171-8.
2. Ravussin E, Lillioja S, Knowler WC, Christin L, Freymond D, Abbott WG, et al. Reduced rate of energy expenditure as a risk factor for body-weight gain. N Engl J Med 1988;318:467-72. 3. Lin YC, Yen LL, Chen SY, Kao MD, Tzeng MS, Huang PC, et al. Prevalence of overweight and obesity and its associated factors: findings from National Nutrition and Health Survey in Taiwan, 1993-1996. Prev Med 2003;37:233-41. 4. Conway B, Rene A. Obesity as a disease: no lightweight matter. Obes Rev 2004;5:145-51. 5. Babb TG, Buskirk ER, Hodgson JL. Exercise end-expiratory lung volumes in lean and moderately obese women. Int J Obes 1989;13:11-9. 6. Biring MS, Lewis MI, Liu JT, Mohsenifar Z. Pulmonary physiologic changes of morbid obesity. Am J Med Sci 1999;318:293-7. 7. Jenkins SC, Moxham J. The effects of mild obesity on lung function. Respir Med 1991;85:309-11. 8. Zerah F, Harf A, Perlemuter L, Lorino H, Lorino AM, AtlanG. Effects of obesity on respiratory resistance. Chest 1993;103:1470-6. 9. Babb TG. Mechanical ventilatory constraints in aging, lung disease, and obesity: perspectives and brief review. Med Sci Sports Exerc 1999;31:S12-22. 10. Johnson BD, Weisman IM, Zeballos RJ, Beck KC. Emerging concepts in the evaluation of ventilatory limitation during exercise: the exercise tidal flow-volume loop. Chest 1999;116:488-503. 11. Calverley PM, Koulouris NG. Flow limitation and dynamic hyperinflation: key concepts in modern respiratory physiology. Eur Respir J 2005;25:186-99. 12. Lotti P, Gigliotti F, Tesi F, Stendardi L, Grazzini M, Duranti R, et al. Respiratory muscles and dyspnea in obese nonsmoking subjects. Lung 2005;183:311-23. 13. Dueck R. Assessment and monitoring of flow limitation and other parameters from flow/volume loops. J Clin Monit Comput 2000;16:425-32. 14. Babb TG, Korzick D, Meador M, Hodgson JL, Buskirk ER. Ventilatory response of moderately obese women to submaximal exercise. Int J Obes 1991;15:59-65. 15. Delorey DS, Wyrick BL, Babb TG. Mild-to-moderate obesity: implications for respiratory mechanics at rest and during exercise in young men. Int J Obes Relat Metab Disord 2005;29:1039-47. 16. Johnson BD, Reddan WG, Seow KC, Dempsey JA. Mechanical constraints on exercise hyperpnea in a fit aging population. Am Rev Respir Dis 1991;143:968-77. 17. Sampson MG, Grassino AE. Load compensation in obese patients during quiet tidal breathing. J Appl Physiol 1983;55:1269-76. 18. Lind F, Hesser CM. Breathing pattern and occlusion pressure during moderate and heavy exercise. Acta Physiol Scand 1984;122:61-9. 19. Ray CS, Sue DY, Bray G, Hansen JE, Wasserman K. Effects of obesity on respiratory function. Am Rev Respir Dis 1983;128:501-6. 20. Burki NK, Baker RW. Ventilatory regulation in eucapnic morbid obesity. Am Rev Respir Dis 1984;129:538-43. 21. Lind F, Hesser CM. Breathing pattern and lung volumes during exercise. Acta Physiol Scand 1984;120:123-9. 22. Whipp BJ, Davis JA. The ventilatory stress of exercise in obesity. Am Rev Respir Dis 1984;129:S90-2. 23. Farkas GA, Roussos C. Acute diaphragmatic shortening: in vitro mechanics and fatigue. Am Rev Respir Dis 1984;130:434-8. 24. Farkas GA, Cerny FJ, Rochester DF. Contractility of the ventilatory pump muscles. Med Sci Sports Exerc 1996;28:1106-14. 25. Babb TG, Viggiano R, Hurley B, Staats B, Rodarte JR. Effect of mild-to-moderate airflow limitation on exercise capacity. J Appl Physiol 1991;70:223-30. 26. Saaresranta T, Polo O. Hormones and breathing. Chest 2002;122:2165-82. 27. 李昭男。更年期保健手冊。台北:行政院衛生署;2002。 28. Department of Health, Executive Yun. R.O.C. Guidelines for definition and treatment of obesity. Taipei: Department of Health, Executive Yun. R.O.C; 2002. 29. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52. 30. Jubber AS. Respiratory complications of obesity. Int J Clin Pract 2004;58:573-80. 31. WHO⁄ IASO ⁄ IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. Copcnhagen: Health Communications Melbourne; 2000. 32. American College of Sports Medicine. ACSM's guildelines for exercise testing and prescription. 6th ed. Pennsylvania: Lippinott Williams & Wilkins; 2006. p 22-5. 33. 林宇旋、張幸貞、陳姿伶。台灣地區婦女更年期身心症狀盛行率及健康相關知識行為–民國91年國民健康促進知識態度與行為調查結果。台北:行政院衛生署國民健康局;2003。 34. Donato GB, Fuchs SC, Oppermann K, Bastos C, Spritzer PM. Association between menopause status and central adiposity measured at different cutoffs of waist circumference and waist-to-hip ratio. Menopause 2006;13:280-5. 35. Van Pelt RE, Jones PP, Davy KP, Desouza CA, Tanaka H, Davy BM, et al. Regular exercise and the age-related decline in resting metabolic rate in women. J Clin Endocrinol Metab 1997;82:3208-12. 36. Poehlman ET, Toth MJ, Gardner AW. Changes in energy balance and body composition at menopause: a controlled longitudinal study. Ann Intern Med 1995;123:673-5. 37. Svendsen OL, Hassager C, Christiansen C. Age- and menopause-associated variations in body composition and fat distribution in healthy women as measured by dual-energy X-ray absorptiometry. Metabolism 1995;44:369-73. 38. Toth MJ, Tchernof A, Sites CK, Poehlman ET. Menopause-related changes in body fat distribution. Ann N Y Acad Sci 2000;904:502-6. 39. Panotopoulos G, Ruiz JC, Raison J, Guy-Grand B, BasdevantA. Menopause, fat and lean distribution in obese women. Maturitas 1996;25:11-9. 40. Rebuffe-Scrive M, Eldh J, Hafstrom LO, Bjorntorp P. Metabolism of mammary, abdominal, and femoral adipocytes in women before and after menopause. Metabolism 1986;35:792-7. 41. Naimark A, Cherniack RM. Compliance of the respiratory system and its components in health and obesity. J Appl Physiol 1960;15:377-82. 42. Unterborn J. Pulmonary function testing in obesity, pregnancy, and extremes of body habitués. Clin Chest Med 2001;22:759-67. 43. Sarikaya S, Cimen OB, Gokcay Y, Erdem R. Pulmonary function tests, respiratory muscle strength, and endurance of persons with obesity. The Endocrinologist 2003;13:136-41. 44. Rubinstein I, Zamel N, DuBarry L, Hoffstein V. Airflow limitation in morbidly obese, nonsmoking men. Ann Intern Med 1990;112:828-32. 45. Fadell EJ, Richman AD, Ward WW, Hendon JR. Fatty infiltration of respiratory muscles in the Pick-wickian syndrome. N Engl J Med 1962;266:861-3. 46. Jones RL, Nzekwu MM. The effects of body mass index on lung volumes. Chest 2006;130:827-33. 47. Bottai M, Pistelli F, Di Pede F, Carrozzi L, Baldacci S, Matteelli G, et al. Longitudinal changes of body mass index, spirometry and diffusion in a general population. Eur Respir J 2002;20:665-73. 48. King GG, Brown NJ, Diba C, Thorpe CW, Munoz P, Marks GB, et al. The effects of body weight on airway calibre. Eur Respir J 2005;25:896-901. 49. Lotti P, Gigliotti F, Tesi F, Stendardi L, Grazzini M, Duranti R, et al. Respiratory muscles and dyspnea in obese nonsmoking subjects. Lung 2005;183:311-23. 50. Lin WY, Yao CA, Wang HC, Huang KC. Impaired lung function is associated with obesity and metabolic syndrome in adults. Obesity 2006;14:1654-61. 51. Babb TG, DeLorey DS, Wyrick BL, Gardner PP. Mild obesity does not limit change in end-expiratory lung volume during cycling in young women. J Appl Physiol 2002;92:2483-90. 52. Lazarus R, Sparrow D, Weiss ST. Effects of obesity and fat distribution on ventilatory function: the normative aging study. Chest 1997;111:891-8. 53. De Lorenzo A, Maiolo C, Mohamed EI, Andreoli A, Petrone-De Luca P, et al. Body composition analysis and changes in airways function in obese adults after hypocaloric diet. Chest 2001;119:1409-15. 54. Chen Y, Horne SL, Dosman JA. Body weight and weight gain related to pulmonary function decline in adults: a six year follow up study. Thorax 1993;48:375-80. 55. West JB. Respiratory physiology: the essentials. 7th ed. Pennsylvania: Lippincott Williams & Wilkins; 2004. p. 106-7. 56. Kress JP, Pohlman AS, Alverdy J, Hall JB. The impact of morbid obesity on oxygen cost of breathing (VO2RESP) at rest. Am J Respir Crit Care Med 1999;160:883-6. 57. Frownfelter D, Dean E. Principle and practice of cardiopulmonary physical therapy. 3rd ed. Missouri: Mosby; 1996. p. 149-50. 58. American Thoracic Society, European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med 2002;166:518-624. 59. Sahebjami H, Gartside PS. Pulmonary function in obese subjects with a normal FEV1/FVC ratio. Chest 1996;110:1425-9. 60. Kelly TM, Jensen RL, Elliott CG, Crapo RO. Maximum respiratory pressures in morbidly obese subjects. Respiration 1988;54:73-7. 61. Wadstrom C, Muller-Suur R, Backman L. Influence of excessive weight loss on respiratory function. A study of obese patients following gastroplasty. Eur J Surg 1991;157:341-6. 62. Wadstrom C, Larsson L, Knutsson E, Edstrom L. The effect of excessive weight loss on skeletal muscle in man. A study of obese patients following gastroplasty. Eur J Surg 1991;157:347-54. 63. El Gamal H, Khayat A, Shikora S, Unterborn JN. Relationship of dyspnea to respiratory drive and pulmonary function tests in obese patients before and after weight loss. Chest 2005;128:3870-4. 64. Weiner P, Waizman J, Weiner M, Rabner M, Magadle R, Zamir D. Influence of excessive weight loss after gastroplasty for morbid obesity on respiratory muscle performance. Thorax 1998;53:39-42. 65. Hakala K, Mustajoki P, Aittomaki J, Sovijarvi,A R. Effect of weight loss and body position on pulmonary function and gas exchange abnormalities in morbid obesity. Int J Obes Relat Metab Disord 1995;19:343-6. 66. Keller U. From obesity to diabetes. Int J Vitam Nutr Res 2006;76:172-7. 67. Lobo RA. Metabolic syndrome after menopause and the role of hormones. Maturitas 2008;60:10-8. 68. Yeh HC, Punjabi NM, Wang NY, Pankow JS, Duncan BB, Cox CE, et al. Cross-sectional and prospective study of lung function in adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes Care 2008;31:741-6. 69. Schuyler MR, Niewoehner DE, Inkley SR, Kohn R. Abnormal lung elasticity in juvenile diabetes mellitus. Am Rev Respir Dis 1976;13:37-41. 70. Benbassat CA, Stern E, Karmer M, Lebzelter J, Blum I, Fink G. Plmonary function in patients with diabetes mellitus. Am J Med Sci 2001;322:127-32. 71. Bell D, Collier A, Matthews DM, Cooksey EJ, McHardy GJ, Clarke BF. Are reduced lung volumes in IDDM due to defect in connective tissue? Diabetes 1988;37:829-31 72. Wang LY, Cerny FJ. Ventilatory response to exercise in simulated obesity by chest loading. Med Sci Sports Exerc 2004;36:780-6. 73. Reinhard U, Muller PH, Schmulling RM. Determination of anaerobic threshold by the ventilation equivalent in normal individuals. Respiration 1979;38:36-42. 74. Whipp BJ, Ward SA, Wasserman K. Ventilatory responses to exercise and their control in man. Am Rev Respir Dis 1984;129:S17-S20. 75. Sahebjami H. Dyspnea in obese healthy men. Chest 1998;114:1373-7. 76. Chernick RM. Respiratory effects of obesity. Can Med Assoc J 1958;80:613-6. 77. Rowland TW. Effects of obesity on aerobic fitness in adolescent females. Am J Dis Child 1991;145:764-8. 78. Marinov B, Kostianev S, Turnovska T. Ventilatory efficiency and rate of perceived exertion in obese and non-obese children performing standardized exercise. Clin Physiol Funct Imaging 2002;22:254-60. 79. West JB. Respiratory physiology: the essentials. 7th ed. Pennsylvania: Lippincott Williams & Wilkins; 2004. p. 80-2. 80. Leslie WD, Dupont JO, Peterdy AE. Effect of obesity on red cell mass results. J Nucl Med 2007;40:422-8. 81. West JB. Respiratory physiology: the essentials. 7th ed. Pennsylvania: Lippincott Williams & Wilkins; 2004. p. 96-7. 82. Remmers JE, Marttila I. Action of intercostal muscle afferents on the respiratory rhythm of anesthetized cats. Respir Physiol 1975;24:31-41. 83. Grodin JM, Siiteri PK, MacDonald PC. Source of estrogen production in postmenopausal women. J Clin Endocrinol Metab 1973;36:207-14. 84. Bayliss DA, Millhorn DE. Central neural mechanisms of progesterone action: application to the respiratory system. J Appl Physiol 1992;73:393-404. 85. Bayliss DA, Cidlowski JA, Millhorn DE. The stimulation of respiration by progesterone in ovariectomized cat is mediated by an estrogen-dependent hypothalamic mechanism requiring gene expression. Endocrinology 1990;126:519-27. 86. Behan M, Zabka AG, Thomas CF, Mitchell GS. Sex steroid hormones and the neural control of breathing. Respir Physiol Neurobiol 2003;136:249-63. 87. West JB. Respiratory physiology: the essential. 7th ed. Pennsylvania: Lippincott Williams & Wilikns; 2005. p. 122-124. 88. Lind FG. Respiratory drive and breathing pattern during exercise in man. Acta Physiol Scand Suppl 1984;533:1-47. 89. Hussain SN, Pardy RL, Dempsey JA. Mechanical impedance as determinant of inspiratory neural drive during exercise in humans. J Appl Physiol 1985;59:365-75. 90. Milic-Emili J. Recent advances in clinical assessment of control of breathing. Lung 1982;160:1-17. 91. Milic-Emili J, Grunstein MM. Drive and timing components of ventilation. Chest 1976;70(Suppl 1):131-3. 92. Whitelaw WA, Derenne JP. Airway occlusion pressure. J Appl Physiol 1993;74:1475-83. 93. Grunstein MM, Younes M, Milic-Emili J. Control of tidal volume and respiratory frequency in anesthetized cats. J Appl Physiol 1973;35:463-76. 94. Burki NK, Mitchell LK, Chaudhary BA, Zechman FW. Measurement of mouth occlusion pressure as an index of respiratory centre output in man. Clin Sci Mol Med 1977;53:117-23. 95. Scott GC, Burki NK. The relationship of resting ventilation to mouth occlusion pressure. An index of resting respiratory function. Chest 1990;98:900-6. 96. Hyatt RE. The interrelationships of pressure, flow, and volume during various respiratory maneuvers in normal and emphysematous subjects. Am Rev Respir Dis 1961;83:676-83. 97. DeLorey DS, Babb TG. Progressive mechanical ventilatory constraints with aging. Am J Respir Crit Care Med 1999;160:169-77. 98. Yan S, Kaminski D, Sliwinski P. Reliability of inspiratory capacity for estimating end-expiratory lung volume changes during exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1997;156:55-9. 99. American College of Sports Medicine. ACSM's guildelines for exercise testing and prescription. 6th ed. Pennsylvania: Lippinott Williams & Wilkins; 2006. p. 50. 100. Rosner B. Fundamentals of biostatistics. 5th ed. CA: Duxbury; 2000. P. 307. 101. World Health Organization. Measuring obesity- classification and description of anthropometric data. Report on a WHO consultation in epidemiology obesity. Copcnhagen: WHO regional office for Europe; 1987. 102. American College of Sports Medicine. ACSM's guildelines for exercise testing and prescription. 6th ed. Pennsylvania: Lippinott Williams & Wilkins; 2006. p. 57-90. 103. Tsao CC, Lin KH, Lai JS, Lan C. Reliability of body fat measurement: skinfold, bioelectrical impedance analysis and infrared. FJPT 1995;20:102-9. 104. Frownfelter D, Dean E. Principle and practice of cardiopulmonary physical therapy. 3rd ed. Missouri: Mosby; 1996. p. 149-50. 105. Berglund E, Birath G, Bjure J, Grimby G, Kjellmer I, Sandqvist L, et al. Spirometric studies in normal subjects. I. Forced expirograms in subjects between 7 and 70 years of age. Acta Med Scand 1963;173:185-92. 106. Crapo RO, Morris AH, Clayton PD, Nixon CR. Lung volumes in healthy nonsmoking adults. Bull Eur Physiopathol Respir 1982;18:419-25 107. Crapo RO, Morris AH, Gardner RM. Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev Respir Dis 1981;123:659-64. 108. Standardization of Spirometry, 1994 Update. American Thoracic Society. Am J Respir Crit Care Med 1995;152:1107-36. 109. Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983;127:725-34. 110. Ofir D, Laveneziana P, Webb KA, O'Donnell DE. Ventilatory and perceptual responses to cycle exercise in obese women. J Appl Physiol 2007;102:2217-26. 111. Janssens JP, Pache JC, Nicod LP. Physiological changes in respiratory function associated with ageing. Eur Respir J 1999;13:197-205. 112. Sarikaya S, Cimen OB, Gokcay Y, Erdem R. Pulmonary function tests, respiratory muscle strength, and endurance of persons with obesity. The Endocrinologist 2003;13:136-41. 113. Chen HI, Kuo CS. Relationship between respiratory muscle function and age, sex, and other factors. J Appl Physiol 1989;66:943-8. 114. Winter EM, Hamley EJ. Sub maximal oxygen uptake related to fat free mass and lean leg volume in trained runners. Br J Sports Med 1976;10:223-5. 115. Wong SY, Chan FW, Lee CK, Li M, Yeung F, Lum CC, et al. Maximum oxygen uptake and body composition of healthy Hong Kong Chinese adult men and women aged 20 - 64 years. J Sports Sci 2008;26:295-302. 116. Mercuro G, Saiu F, Deidda M, Mercuro S, Vitale C, Rosano GM. Impairment of physical exercise capacity in healthy postmenopausal women. Am Heart J 2006;151:923-7. 117. Mercuro G, Longu G, Zoncu S, Cherchi A. Impaired forearm blood flow and vasodilator reserve in healthy postmenopausal women. Am Heart J 1999;137:692-7. 118. Wolfe LA, Hodgson JL, Barlett HL, Nicholas WC, Buskirk ER. Pulmonary function at rest and during exercise in uncomplicated obesity. Res Q 1976;47:829-38. 119. Luthi M, Roach DE, Beaudin AE, Debert CT, Sheldon RS, Poulin MJ. Effects of ovarian hormones and aging on respiratory sinus arrhythmia and breathing patterns in women. Clin Auton Res 2008;18:134-44. 120. Ardevol A, Adan C, Franco L, Garcia-Lorda P, Rubio F, Remesar X, et al. During intense exercise, obese women rely more than lean women on aerobic energy. Pflugers Arch 1998;435:495-502. 121. Rosner B. Fundamentals of biostatistics. 5th ed. CA: Duxbury; 2000. P. 309. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/41573 | - |
dc.description.abstract | 背景與目的:肥胖相關的肺容積變化會改變呼吸機械機制(mechanism)。在運動過程中,這些機械機制的改變會增加產生吐氣氣流限制的機會進而影響運動能力。雌激素和黃體素對呼吸是正向的刺激因子,這些荷爾蒙對呼吸的調控會隨著停經狀態而調降。因此,我們推論肥胖合併停經造成性荷爾蒙的下降會導致這些婦女更容易在運動中產生呼吸機械性限制,進而惡化運動呼吸困難的感覺及降低運動能力。本研究目的是探討肥胖停經後婦女在運動過程中的動態肺功能變化,及這些變化與呼吸困難之間的關係。方法及分析:經由醫師轉介及廣告徵集,本研究有24位肥胖(身體質量指數 ≧ 27公斤/尺2)及26位非肥胖停經後婦女參與。所有受試者均接受以下測量╱試。休息狀態下先進行肺功能及身體組成的分析測量。接著測量基線的最大氣流-容積曲線。進行漸進式漸進式最大運動測試以固定式腳踏車進行,運動強度每3分鐘增加25瓦。在運動測試的每個運動強度,會以運動中吸氣容積(inspiratory capacity, IC)來計算吐氣末肺容積(end-expiratory lung volume, EELV)與吸氣末肺容積(end-inspiratory lung volume, EILV)變化,並以視覺等比量表測量呼吸困難及下肢疲乏程度。兩組間基本資料及運動測試結果(連續性變相)以t檢定來分析組別間是否有差異。運動中的變相改變則以重覆量數兩因子變異數分析及Bonferroni檢定作事後分析來分析組間及組內的差異。定義p < 0.05有統計上的意義。結果與討論:肥胖組全肺總容積、吐氣保留容積、功能貯備、用力呼氣肺活量、第一秒用力呼氣容積、及相對最高攝氧量(relative VO2peak)與最高心跳均顯著小於控制組(p < 0.05)。肥胖組EELV會隨著運動強度上升而逐漸上升並產生機械性換氣限制。運動過程中,每分鐘換氣量(minute ventilation, VE)、潮氣量(tidal volume, Vt)、平均吸氣流速(mean inspiratory flow, Vt/TI)與呼吸困難程度有顯著組間差異(肥胖組 > 控制組)肥胖組中,中重度的EELV變化幅度較輕度者為大。EILV及EELV的變化與呼吸困難分別呈低及中度顯著相關且相關強度會受肥胖嚴重度的影響。結論:停經後婦女在運動中,動態肺容積的變化模式在肥胖和正常體重的受試者有所不同。肥胖的停經後婦女在運動過程中會發生機械性換氣限制現象。且呼吸困難程度和動態肺容積變化具顯著正相關。 | zh_TW |
dc.description.abstract | Background/Purpose: Obesity-related changes in lung volumes have shown to affect breathing mechanisms. During exercise, altered breathing mechanisms increase potential for expiratory flow limitation and compromise exercise capacity. Estrogen and progesterone are potent respiratory stimulants, and their effects in the physiologic regulation of breathing are down-regulated after menopause. Therefore, we theorized that the combined obesity and reduced sex hormone levels after menopause work as a double jeopardy to cause mechanical ventilatory constraint which aggravates dyspnea sensation during exercise, and thus a reduction in exercise capacity. The purpose of this study was to exam the dynamic lung volumes in obese post-menopausal women (without hormone replacement therapy) during exercise and their correlations with dyspnea. Methods and Analysis: From doctoral referral and advertisement, 24 obese (BMI ≧ 27 kg/m2) and 26 lean post-menopausal women were recruited for the study. Pulmonary function and body composition were measured at rest. A maximal flow volume loop (MFVL) was obtained at baseline. All subjects then performed an incremental exercise test on a cycle ergometer with workload increasing 25 watts every 3 min. During exercise, at each workload, the tidal exercise FV loops were obtained and an inspiratory capacity (IC) maneuver was conducted to assess changes in end-expiratory lung volume (EELV) and end inspiratory lung volume (EILV). Dyspnea and leg fatigue were assessed using the Borg scale. Analysis of variance with repeated measurements was used to test the significance of the mean differences between the two groups during exercise. Linear regression analysis was used to determine whether changes in dynamic lung volumes during exercise were related to changes in Borg scores. Statistical significance was established at p < 0.05. Results and Discussion: Functional residual capacity (FRC), expiratory reserved volume (ERV), and total lung capacity (TLC) were significantly lower in the obese group than those in the control group (all p < 0.05). Compared to control, relative peak oxygen consumption (VO2peak) and heart rate (HRpeak) were significantly lower in obese group. Obese subjects demonstrated mechanical ventilatory constraint with elevated EELV during exercise. Minute ventilation (VE), tidal volume (Vt), mean inspiratory flow (Vt/TI), and dyspnea score were significantly higher in the obese then those in the control group during exercise. In the obese group, moderate to severe obese subjects showed greater changes in EILV and EELV compared to those of mild obese. In obese group, changes EILV and EELV were found to have mild and moderate correlation with the dyspnea scores, respectively, and the obese severity could influence the correlation strength. Conclusions: Patterns of dynamic lung volume changes were different between obese and lean post-menopausal women. Obese post-menopausal women demonstrated mild degree of mechanical ventilatory constraint during exercise and changes in dynamic lung volumes were significant positively correlated with dyspnea sensation. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T00:23:31Z (GMT). No. of bitstreams: 1 ntu-98-R93428003-1.pdf: 858151 bytes, checksum: 4e0b25f49ff5b75c838df3fd942bea10 (MD5) Previous issue date: 2009 | en |
dc.description.tableofcontents | 口試委員審定書……………………………………………………………………………………….i
致謝……………………………………………………………………………………………..……. ii 中文摘要……………………………………………………………………………………………...iii 英文摘要……………………………………………………………………………………………....v 第一章、前言……………………………………………………………………………….……...…..1 第一節、研究背景與目的……………………….………………………………………………1 第二節、名詞及變項定義……………………………………….………………………………3 第三節、研究假說……………………………………………………………….………………5 第四節、研究重要性……………………………………………………………..........................7 第二章、文獻回顧……………………………………………………………………..........................8 第一節、肥胖與停經後婦女……………………………………………………………………..8 第二節、肥胖對呼吸系統的影響………………………………………………………………10 第三節、肥胖對運動中呼吸模式、換氣反應與運動中潮氣–容積曲線的影響………………15 第四節、女性荷爾蒙對呼吸控制之角色……………………………………………………....19 第五節、呼吸控制之評估………………………………………………………………………23 第六節、機械性換氣限制現象之測量…………………………………………………………23 第三章、研究方法……………………………………………………………………………………24 第一節、受試者…………………………………………………………………………………24 第二節、研究進行步驟…………………………………………………………………………24 第三節、測量工具與測試方法…………………………………………………………………25 第四節、資料處理與統計分析…………………………………………………………………31 第四章、結果…………………………………………………………………………………………32 第一節、受試者基本資料………………………………………………………………………32 第二節、肺功能測試結果………………………………………………………………………33 第三節、漸進式最大運動測試結果……………………………………………………………33 第四節、漸進式最大運動測試中動態肺容量變化……………………………………………34 第五節、漸進式最大運動測試中攝氧量、二氧化碳生成量與換氣反應變化………………35 第六節、漸進式最大運動測試中呼吸模式與心跳變化………………………………………36 第七節、視覺等比量表與動態肺容積變化之相關性…………………………………………37 第八節、各肥胖等級之結果比較………………………………………………………………37 第五章、討論………………………………………………………………………………………..40 第一節、主要結果........................................................................................................................40 第二節、肺功能結果...................................................................................................................40 第三節、漸進式最大運動測試結果...........................................................................................42 第四節、漸進式最大運動測試中動態肺容量與視覺等比量表變化........................................43 第五節、漸進式最大運動測試中換氣反應、呼吸模式變化......................................................45 第六節、研究限制.......................................................................................................................46 第五章、結論………………………………………………………………………………………..47 參考文獻……………………………………………………………………………………………..48 | |
dc.language.iso | zh-TW | |
dc.title | 肥胖停經後婦女運動中機械性換氣限制、呼吸模式與換氣反應之探討 | zh_TW |
dc.title | Mechanical ventilatory constraint, breathing pattern and ventilatory responses in obese postmenopausal women during exercise | en |
dc.type | Thesis | |
dc.date.schoolyear | 97-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 吳英黛(Ying-Tai Wu),黃國晉(Kuo-Chin Huang),吳惠東(Huey-Dong Wu) | |
dc.subject.keyword | 肥胖,停經後婦女,機械性換氣限制現象,動態肺容量,吐氣氣流限制, | zh_TW |
dc.subject.keyword | Obesity,Postmenopausal women,Mechanical ventilatory constraints,Dynamic lung volume,Expiratory flow limitation, | en |
dc.relation.page | 90 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2009-02-02 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 物理治療學研究所 | zh_TW |
顯示於系所單位: | 物理治療學系所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-98-1.pdf 目前未授權公開取用 | 838.04 kB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。