心率变异和心肺功能试验对先天性心脏病术后危险性的预测  

The predictive value of heart rate variation and cardiopulmonary exercisetesting to the congenital heart disease patients after operation

作　　者：王红宇[1] 李琦[1] 李黎[2] 邢万红[3] 

机构地区：[1]山西医科大学第二医院综检室,030001 [2]山西医科大学第二医院呼吸科,030001 [3]山西医科大学第二医院胸外科,030001

出　　处：《中国药物与临床》2005年第4期259-262,共4页Chinese Remedies & Clinics

基　　金：山西省自然科学基金资助项目(981071)

摘　　要：目的通过对先天性心脏病开胸术患者和健康对照组的研究,确立一些新的对术后近期并发症危险性有预测价值的指标。方法45例开胸术患者和45名健康人分别作为病例组和对照组,病例组组内比较时,根据术后近期并发症严重程度进行分级,收集入选者的临床资料、动态心电图和心肺功能试验数据等资料。结果①开胸术患者的最大通气量(MV)、呼吸商(RQ)、最大摄氧量(VO2max)、最大二氧化碳排出量(VCO2max)、最大氧脉搏(VO2max/HR)、最大公斤摄氧量(VO2max/kg)、最大氧代谢(MET)、无氧域(ATVO2max)、最大功率负荷(Wmax)、运动时间、高频(HF)、低频(LF)等指标明显低于正常对照组;②心率变异性和心肺功能试验指标与开胸术后近期并发症严重程度存在相关性。③可信度最高的是Wmax达到0.898,其次是VO2max/kg和HF(静息状态)分别达到0.875和0.813。相比较而言,ATVO2max和VO2max信度比较低分别是0.789和0.766。结论心率变异和运动心肺功能试验可能成为新的预测开胸术后近期并发症的方法,Wmax、VO2max/kg和HF为较好的预测指标。Objective We want to obtain some new indices to predict the complications of congenital heart disease (CHD) patients after their operations by comparing them between the patients and health persons also among the patients themselves.Methods forty-five patients have been diagnosed exactly as CHD in hospital,at the same time 45 health persons are collected as control.According to the degree of complications,CHD patients are marked by a content number.The basic information,dynamic electrocardiogram(DCG)and the cardiopulmonary exercise testing(ERGO-OXYSCREEN) of those subjects have been got,and three kind of information such as basic information,heart electrophysiologic indices,heart reserved cardiac functional signs etc been drawn cut.Results ①The MV,RQ,VO2max,VCO2max,VO2max/HR,VO2max/kg,MET,ATVO2max,Wmax,exercise duration,HF,LF of the CHD patients are significantly lower than those of the control group.②The occurrence frequency and serious degrees of the post-operative complications are related with HRV,Wmax,VO2max/kg and HF in stable state,ATO2max,VO2max.③The highest diagnostic credibllity is Wmax,the middle ones are VO2max/kg and HF in stable state.Conclusion The heart rate variability and Wmax,VO2max/kg and HF in stable state,ATO2max,VO2max maybe become the newly worthy indexes to complications of CHD patients.

关 键 词：先天性心脏病 术后近期并发症 VO2MAX 运动心肺功能试验 严重程度 健康对照组 动态心电图 最大通气量 最大摄氧量 正常对照组 心率变异性 开胸术 预测价值 临床资料 试验数据 二氧化碳 运动时间 试验指标 静息状态 预测指标 

分 类 号：R654.2[医药卫生—外科学]