纵隔疾病患者运动心肺功能特点研究  

Characteristics of Cardiopulmonary Function during Exercise in Patients with Mediastinal Diseases

作　　者：操敏[1] 王志茹[1] 张国红[1] 孙桂新[1] 阮洪云[1] 邓玲[1] 邢维祥 李琦[1] 

机构地区：[1]首都医科大学附属北京胸科医院心肺功能室,北京市101149

出　　处：《中国全科医学》2017年第36期4489-4494,共6页Chinese General Practice

摘　　要：目的探讨纵隔疾病患者运动心肺功能的特点及其可能的影响因素。方法回顾性选取2014年11月—2016年11月于首都医科大学附属北京胸科医院住院的符合纳入标准的纵隔疾病患者44例为病例组,选取同期于本院住院的静息心电图、静息肺功能正常及心电图运动试验阴性的非纵隔疾病患者32例为对照组。按病变周围有无血管受侵,将病例组分为有血管受侵亚组(34例)和无血管受侵亚组(10例)。根据病变部位,将病例组分为前纵隔亚组(34例)和中、后纵隔亚组(10例)。记录患者静息心电图检查、静息肺功能检查、心肺运动试验(CPET)相应观察指标。结果所有患者静息心电图呈窦性心律,无缺血性ST-T段改变。病例组肺活量占预计值百分比(VC%)低于对照组,残气量/肺总量(RV/TLC)、总气道阻力占预计值百分比(R_5%)高于对照组(P<0.05)。病例组运动负荷占预计值百分比(W%)、最大摄氧量占预计值百分比(VO_2%)、氧脉搏占预计值百分比(VO_2/HR%)、呼气潮气容积(VTex)、潮气容积/肺活量(VT/VC)、血氧饱和度(SpO_2)低于对照组,呼吸频率(BF)高于对照组(P<0.05)。中、后纵隔亚组W%、呼吸储备(BR)高于前纵隔亚组,呼吸困难指数(DI)低于前纵隔亚组(P<0.05)。有血管受侵亚组W%低于无血管受侵亚组(P<0.05)。结论纵隔疾病患者运动耐力、运动心功能、运动肺功能均下降。患者的静息肺功能、纵隔病变部位及血管受侵可能对其运动心肺功能有一定影响。Objective To explore the characteristics and possible associated factors of cardiopulmonary function during exercise in patients with mediastinal diseases. Methods This retrospective study was conducted in 76 participants meeting the inclusion criteria who received inpatient treatment in Beijing Chest Hospital,Capital Medical University from November 2014 to November 2016,including 44 cases of mediastinal diseases（ case group）,and 32 cases with normal resting electrocardiogram,normal resting pulmonary function and normal exercise electrocardiogram（ control group）. We divided the case group into vessel invasion subgroup（ n = 34） and non-vessel invasion subgroup（ n = 10） based on the vessels being invaded by the lesion or not. We divided the case group into anterior mediastinal subgroup（ n = 34） and middle and back mediastinal subgroup（ n = 10）based on the position of lesion. The rest electrocardiogram,resting pulmonary function and cardiopulmonary exercise test（ CPET）were measured,and the data of these measurements in all the patients were recorded. Results The rest electrocardiogram of all the patients presented normal sinus rhythm without ischemic ST-segment and T wave changes. Vital capacity% predicted（ VC%） in case group was smaller than that in control group,but ratio of residual volume to total lung capacity（ RV/TLC） and resistance at 5 Hz% predicted（ R_5%） in case group were higher than those in control group（ P 0. 05）. Compared with the control group,the case group had lower values of exercise Watt % predicted（ W%）,maximal oxygen uptake % predicted（ VO_2%）,oxygen pulse % predicted（ VO_2/HR%）,expiratory tidal volume（ VTex）,ratio of tidal volume to vital capacity（ VT/VC） and transcutaneous oxygen saturation of hemoglobin（ SpO_2） but higher breathing frequency（ BF）（ P 0. 05）.W% and breathing reserve（ BR） in the middle and back mediastinal subgroup were higher than those in anterior mediastinal subgroup（ P 0. 05）. Lower dysp

关 键 词：纵隔疾病 运动心肺功能 心肺运动试验 

分 类 号：R564[医药卫生—呼吸系统]