无症状先天性心脏病患者心脏储备功能的评价  

Reserved Cardiac Function in Asymptomatic Congenital Heart Disease Patient

作　　者：邢万红[1] 李家成[1] 王红宇[2] 李黎[2] 

机构地区：[1]山西医科大学第二医院心胸外科,太原030001 [2]山西医科大学第二医院综合检查科

出　　处：《中国胸心血管外科临床杂志》2002年第1期8-10,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：山西省自然科学基金资助项目 ( 9810 71)

摘　　要：目的　探讨无症状先天性心脏病 (CHD)患者的心脏储备功能 ,为拟定治疗方案提供依据。　方法　应用Jaeger公司生产的运动心肺功能仪 (功率自行车 ) ,采用 ramp- pattern方案 ,对 2 0例无症状 CHD患者 (研究组 )和 2 0例健康人 (对照组 )作心肺运动试验 ,记录两组心肺功能指标 ,包括摄氧量 (VO2 )、公斤摄氧量 (VO2 /kg)、增加负荷 (功率 )、二氧化碳排出量 (VCO2 ) ,以得出最大摄氧量 (VO2 max)、最大公斤摄氧量 (VO2 max/kg)、无氧阈时的摄氧量(ATVO2 )、最大心率 (HRmax)等结果。　结果　研究组术后 6个月 VO2 max、VO2 max/kg和 ATVO2 显著高于术前(P=0 .0 39,0 .0 2 7,0 .0 13) ,HRmax显著低于术前 (P=0 .0 0 1) ;研究组术前 VO2 max、VO2 max/kg和 ATVO2 显著低于对照组 (P=0 .0 0 1,0 .0 0 1,0 .0 0 1) ;研究组术后 6个月 VO2 max、VO2 m ax/kg和 HRmax显著低于对照组 (P=0 .0 43,0 .0 2 4,0 .0 0 1)。　结论　无症状 CHD患者心脏储备功能减低 ,术后 6个月心功能较术前明显改善 ,但尚未达到正常水平 。Objective To assess the reserved cardiac function of asymptomatic congenital heart disease patient. Methods Using the cardiopulmonary exercise functional machine (ERGO OXYSCREEN produced by Jaeger Company) with ramp pattern design,the patients of asymptomatic congenital heart disease (study group, n =20)and the healthy persons (control group, n =20) were received cardiopulmonary exercise testing. The cardiopulmonary functional data were measured in two groups,including oxygen uptake(VO 2),relative oxygen uptake(VO 2/kg),word load,carbon dioxide production (VCO 2),etc. Results Comparing with those before operation, maximum oxygen consumption (VO 2max), maximum oxygen consumption per kilogram (VO 2max/kg), VO 2 at anaerobic threshold (ATVO 2) in study group after six months of operation were higher ( P= 0.039, 0.027, 0.013), HRmax was lower ( P= 0.001). Comparison between groups, VO 2max, VO 2max/kg, ATVO 2 of study group before operation were lower than those in control group ( P= 0.001,0.001,0 001); VO 2max,VO 2max/kg, and HRmax of study group after six months of operation were lower than those in control group( P= 0.043, 0.024, 0.001). Conclusion The reserved cardiac function of asymptomatic congenital heart disease patients was reduced. Six months after operation, the cardiac function of the patients was superior to that before operation, but have not attained the normal level. Sinoatrial node response to exercise was attenuated at the sixth month after operation.

关 键 词：先天性心脏病 心肺运动试验 心脏储备功能 CHD 

分 类 号：R654.2[医药卫生—外科学]