心肺运动试验评估慢性左心衰竭患者的运动能力  

Cardiopulmonary Exercise Testing Assessment of Exercise Capacity in Patients With Chronic Left Heart Failure

作　　者：赵青[1] 柳志红[1] 孙兴国 赵智慧[1] 罗勤[1] 马秀平[1] 张洪亮[1] 王勇[1] 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院肺血管病诊治中心,北京市100037 [2]美国Harbor-UCLA医学中心洛杉矶生物医学研究所圣约翰心血管研究中心

出　　处：《中国循环杂志》2011年第5期370-373,共4页Chinese Circulation Journal

摘　　要：目的:应用心肺运动试验(CPET)评估国人慢性左心衰竭患者的运动能力。方法:入选2010-08至2010-12期间入住本中心的慢性左心衰竭患者20例(心衰组),并选择27例心肺功能正常的匹配人群作为对照组,均进行CPET,同时收集两组人群的临床资料和常规检查结果。结果:运动过程中,心衰组较对照组峰值心率、峰值收缩压、无氧域、峰值氧摄取量、峰值氧摄取量占预计值的百分比(峰值VO2/Pred.)、峰值氧脉搏等指标均显著降低(P<0.001或<0.05),而二氧化碳通气当量(VE/VCO2)斜率显著升高(P<0.01),差异均有统计学意义。校正年龄、性别、体重指数后,偏相关分析结果提示氨基末端B型脑钠肽原(NT-proBNP)仍与VE/VCO2斜率相关性最高(r=0.685,P<0.001);左心室射血分数与峰值氧摄取量相关性最高(r=0.679,P<0.001);峰值心率与峰值VO2/Pred.相关性最高(r=0.791,P<0.001);峰值收缩压与峰值氧摄取量相关性最高(r=0.677,P<0.001);而且,用力肺活量、一秒量均与峰值氧摄取量相关性最高(分别为r=0.559,P<0.001和r=0.589,P<0.001)。结论:CPET可以客观、定量地评价慢性左心衰竭患者的运动能力。Objective：To assess the exercise capacity in patients with chronic left heart failure （CHF） by cardiopuhnonary exercise testing （CPET）. Methods：Our work included two groups,CHF group, n = 20, the patients were treated in our center from August to December 2010 and Control group,n = 27 ,the subjects with normal cardiopuhrtonary function. CPET was performed and the general clinical information were collected and compared between two groups. Results：Compared with Control group, the peak heart rate, peak systolic blood pressure, diastolic, blood pressure, the anaerobic threshold,peak VO2 ,peak VO2/pred, peak oxygen pulse were significantly decreased in CHF group,P〈0. 001 or P〈0. 05, while VE/VCO2 slope was significantly increased in CHF group,P〈0. 01. By Pearson and partied correlation analysis, NT-proBNP was mostly correlated to VE/VCO2 slope （r= 0. 685, P〈0. 001 ）, LVEF was mostly correlated to peak VO2 （r = 0. 679, P〈0. 001 ）, the peak heart rate was mostly correlated to peak VO2/pred （r = 0. 791 ,P〈0. 001 ）, peak systolic blood pressure was mostly correlated to poak VO2 （r= 0. 677, P〈0. 001 ）. In addition, FVC and FEVI were closely related to peak VO2（ r=0. 559 ,P〈0. 001 and r=0. 589 ,P〈0. 001 respectively）. Conclusion：CPET can objectively and quantitatively evaluate the exereise capacity in patients with chronic leti heart failure.

关 键 词：慢性左心衰竭 心肺运动试验 氨基末端B型脑钠肽原 左心室射血分数 

分 类 号：R54[医药卫生—心血管疾病]