频发室性早搏患儿心脏储备功能的变化及心肺运动试验的应用研究  

Effect of frequent premature ventricular contraction on cardiac reserve function in children and clinical application of cardiopulmonary exercise test

作　　者：郑彤[1] 汪芸[1] 刘艳[1] 任军[1] 赵地[1] 石琳[1] 

机构地区：[1]首都儿科研究所附属儿童医院心内科,北京100020

出　　处：《中国小儿急救医学》2012年第2期144-147,共4页Chinese Pediatric Emergency Medicine

基　　金：首都医学发展科研基金（2002-1026）

摘　　要：目的观察频发室性早搏（prematureventricularcontraction，PVC）患儿磷酸肌酸治疗前、后的心肺运动试验（cardiopulmonaryexercisetest，CPET）各项参数变化，比较与正常儿童的差异，了解频发PVC对患儿心脏储备功能的影响。方法采用心肺运动测试系统和活动平板对109例频发PVC患儿于治疗前、后分别进行CPET及98例健康儿童进行CPET，记录3组CPET指标，包括最大公斤体重摄氧量（maximaloxygenconsumption／kg，V02max／kg）、最大每搏摄氧量（maximaloxygenconsumption／heartrate，VO，max／HR）、不同时段HR、无氧阈（anaerobicthreshold，AT）、无氧阈占预计最大摄氧量的百分比（AT／V02maxpred）。结果频发PVC患儿组磷酸肌酸治疗前V02max／kg、V02max／HR及AT分别为（22．9±7．4）ml／（kg·min）、（9．3±1．5）ml、（15．5±2．7）ml／（k·min），治疗后分别为（26．4±6．0）ml／（kg·min）、（11．4±3．3）ml、（17．4±3．8）ml／（k·min），频发PVC患儿治疗后V02max／kg、VO：max／HR、AT明显高于治疗前，差异均有统计学意义：V02max／kg（t=2．11，P〈0．001）、V02max／HR（t=4．02，P〈0．001）、AT（t=10．2，P〈0．001）。健康对照组进行的运动试验结果判定皆为阴性。结论频发PVC患儿心脏储备功能降低，经临床治疗后，运动耐力得到改善，心脏储备功能增强，CPET可较好地反映患儿心脏储备功能的变化。Objective To observe the changes in cardiopulmonary exercise test （CPET） variables of children with frequent premature ventricular contraction （PVC） before and after creatine phosphate treatment, to examine the difference of CPET results between PVC patients and healthy children, and to evaluate the effect of frequent PVC on the cardiac reserve function in children. Methods One hundred and nine frequent PVC chil- dren and 98 healthy children underwent treadmill exercise test and CPET respectively, the changes of CPET variables were observed among patients before and after treatment as well as among the healthy children. CPET variables include maximal oxygen consumption/kg （VO2max/kg）, maximal oxygen consumption/ heart rate（ VO2max/HR） , HR（ at different time point）, anaerobic threshold （ AT）, and AT/VO2 maximum prediction （AT/VO2max pred）. Results Before creatine phosphate treatment, VO2max/kg, VO2max/HR and AT/VO2max in frequent PVC children were （22. 9± 7.4） ml/（ kg. min）, （9. 3 ±1.5 ） ml, （ 15.5± 2. 7 ） ml/（ kg. min）. After creatine phosphate treatment, VO2 max/kg, VO2 max/HR and AT/VO2 max were （26.4±6. 0） ml/（kg.min）, （ 11.4 ±3.3） ml,and （ 17.4 ±3.8） ml/（kg.min）. These CPET variables after creatine phosphate treatment in frequent PVC children were obviously higher than those before treatment and there was a significant difference [ VO2 max/kg （ t = 2.11, P 〈 0. 001 ）, VO2 max/HR （ t = 4.02, P 〈 0.001 ）, AT（ t = 10. 2, P 〈 0. 001 ） ]. Control group of 98 healthy children had negative CPET results. Conclusion Cardiac reserve function decreases in frequent PVC children. After treatment, the exercise capacity and cardiac reserve function can be improved. CPET can reflect cardiac functional reserve changes in PVC children.

关 键 词：频发室性早搏 心肺运动试验 儿童 

分 类 号：R541.7[医药卫生—心血管疾病]