四肢联动在脊髓损伤患者心肺功能评估中的可行性研究  

Feasibility of Limbs Linkage in Evaluation of Cardiopulmonary Function in Patients with Spinal Cord Injury

作　　者：张秋阳 钱贞 李瑾 王济红 陈伟 ZHANG Qiuyang;QIAN Zhen;LI Jin;WANG Jihong;CHEN Wei(Xuzhou Medical University,Xuzhou 221000,China;Dean Hospital of Changzhou,Changzhou 213000,China;Xuzhou Rehabilitation Hospital,Xuzhou 221000,China)

机构地区：[1]徐州医科大学,江苏省徐州市221000 [2]江苏省常州市德安医院,213000 [3]江苏省徐州市康复医院,221000

出　　处：《实用心脑肺血管病杂志》2019年第11期16-20,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：徐州市科技计划项目（KC18184)

摘　　要：目的探讨四肢联动在脊髓损伤患者心肺功能评估中的可行性。方法选取徐州市中心医院康复医学科2016-2018年收治的脊髓损伤患者30例,分别使用四肢联动、上肢功率车进行心肺运动试验(CPET),比较两种试验结果[包括静息心率(HRrest)、峰值心率(HRpeak)、静息舒张压(DBPrest)、静息收缩压(SBPrest)、峰值舒张压(DBPpeak)、峰值收缩压(SBPpeak)、峰值摄氧量(VO2peak)、峰值摄氧量/预测摄氧量(VO2peak/VO2pred)、无氧域时摄氧量(VO2AT)、峰值分钟通气量(VEpeak)、峰值呼吸交换率(RERpeak)、峰值代谢当量(METpeak)及峰值氧脉搏(VO2/HRpeak)]及试验完成即刻呼吸困难评分、腿部疲劳程度评分;两种试验过程中HRpeak、VO2peak的相关性分析采用Pearson相关分析。结果(1)所有患者完成四肢联动及上肢功率车试验,无一例出现心血管不良事件。四肢联动试验与上肢功率车试验过程中HRrest、DBPrest、SBPreat、DBPpeak、SBPpeak及VO2peak/VO2pred比较,差异无统计学意义(P>0.05);四肢联动试验过程中HRpeak、VO2peak、VO2AT、VEpeak、RERpeak、METpeak及VO2/HRpeak高于上肢功率车试验(P<0.05)。(2)Pearson相关分析结果显示,四肢联动与上肢功率车试验过程中HRpeak(r=0.93)、VO2/HRpeak(r=0.89)均呈正相关(P<0.05)。(3)四肢联动试验完成即刻呼吸困难评分和腿部疲劳程度评分低于上肢功率车(P<0.05)。结论与上肢功率车相比,使用四肢联动进行CPET能更有效地增加脊髓损伤患者运动强度,从而更加准确地评估心肺功能,且患者疲劳感轻微,因此四肢联动可能更适合用于脊髓损伤患者的心肺功能评估。Objective To investigate the feasibility of limbs linkage in evaluation of cardiopulmonary function in patients with spinal cord injury.Methods From 2016 to 2018,a total of 30 patients with spinal cord injury were selected in the Department of Rehabilitation Medicine,Xuzhou Central Hospital,and all of them carried out the cardiopulmonary exercise test(CPET)by using limbs linkage equipment and upper limb cycle ergometer,respectively.Limbs linkage equipment test results and upper limb cycle ergometer test results were compared,including HRrest,HRpeak,DBPrest,SBPrest,DBPpeak,SBPpeak,VO2 peak,VO2 peak/VO2 pred,VO2 AT,VEpeak,RERpeak,METpeak and VO2/HRpeak during testing,as well as dyspnea score and leg fatigue degree score immediately after test;Pearson correlation analysis was used to analyze the correlation between HRpeak and VO2/HRpeak during testing of limbs linkage equipment test and upper limb cycle ergometer test.Results(1)All of the 30 patients successfully completed the limbs linkage equipment test and upper limb cycle ergometer test,no one occurred cardiovascular adverse events.There was no statistically significant difference in HRrest,DBPrest,SBPrest,DBPpeak,SBPpeakor VO2 peak/VO2 pred between limbs linkage equipment test and upper limb cycle ergometer test during testing(P>0.05),while HRpeak,VO2 peak,VO2 AT,VEpeak,RERpeak,METpeak and VO2/HRpeak during limbs linkage equipment test were statistically significantly higher than those during upper limb cycle ergometer test(P<0.05).(2)Pearson correlation analysis results showed positive correlations in HRpeak(r=0.93)and VO2/HRpeak(r=0.89)during testing between limbs linkage equipment test and upper limb cycle ergometer test(P<0.05).(3)Dyspnea score and leg fatigue degree score immediately after limbs linkage equipment test were statistically significantly lower than those immediately after upper limb cycle ergometer test(P<0.05).Conclusion Compared to upper limb cycle ergometer,CPET by using limbs linkage equipment test can more effectively increase the exercis

关 键 词：脊髓损伤 四肢联动 上肢功率车 心肺运动试验 心肺功能 可行性研究 

分 类 号：R651.2[医药卫生—外科学]