心肺运动试验用于射血分数保留心衰患者的诊断价值研究  

The diagnostic value of cardiopulmonary exercise test in patients with heart failure with preserved ejection fraction

作　　者：张振[1] 张光芳[1] 陈彦波[1] 刘学刚 张爱元[1] ZHANG Zhen;ZHANG Guangfang;CHEN Yanbo;LIU Xuegang;ZHANG Aiyuan(Department of Cardiology,Weifang People's Hospital,Weifang 261041,China)

机构地区：[1]潍坊市人民医院心内科,山东潍坊261041

出　　处：《潍坊医学院学报》2020年第5期335-338,共4页Acta Academiae Medicinae Weifang

基　　金：潍坊市科技发展计划项目(项目编号:2017YX002)。

摘　　要：目的分析心肺运动试验检测射血分数保留心衰患者的气体代谢异常,指导临床诊断。方法 60例患者分为心衰组及对照组,通过心肺运动试验比较两组患者的气体代谢指标。结果同对照组比较,心衰组患者的峰值摄氧量、峰值公斤摄氧量、峰值功率、二氧化碳排出量、无氧阈、氧脉搏、摄氧量/功率斜率以及摄氧效率斜率明显下降,VE/VCO2斜率及无氧阈时二氧化碳代谢当量则明显升高。另外,运动振荡通气(EOV)和呼吸不稳定现象、氧脉搏出现平台及VO2增加率的下降对于射血分数保留的心力衰竭有诊断价值。结论通过心肺运动试验可发现射血分数保留的心力衰竭患者的气体代谢异常,对症状不显著的患者,可指导早期临床诊断,是对目前诊断方式的很好补充。Objective Cardiopulmonary exercise test was used to detect abnormal gas metabolism in heart failure patients with ejection fraction retention for early clinical diagnosis.Methods Sixty patients admitted to the Department of Cardiology were divided into the heart failure group and the normal heart function group.The gas metabolism indexes of the two groups were compared by cardiopulmonary exercise test.Results Compared with the normal heart function group,the peak oxygen uptake,peak kilogram oxygen uptake,power peak,carbon dioxide output,anaerobic threshold,oxygen pulse,oxygen uptake/power slope and OUES decreased significantly,while VE/VCO2 slope and anaerobic the threshold carbon dioxide metabolic equivalent was significantly increased.Exercise oscillatory breathing(EOV) and respiratory instability,oxygen pulse appearance,and decreased VO2 rate have diagnostic value for heart failure with ejection fraction retention.Conclusion CPET can be used to find abnormal gas metabolism in patients with heart failure who have ejection fractions,especially in patients with insignificant symptoms,which can guide early clinical diagnosis and is a good complement to current diagnostic methods.

关 键 词：心肺运动试验 射血分数保留的心衰 气体代谢 

分 类 号：R541.6[医药卫生—心血管疾病]