AECOPD合并右心功能不全患者6分钟步行试验前后心肺功能的变化  

Changes of Cardiopulmonary Function in AECOPD Patients with Right Ventricular Dysfunction Before and After 6-minute Walking Test

作　　者：哈斯叶提·吐尔逊 肖春红[1] 艾尔西丁·吾斯曼[1] 梁玥[1] 穆叶赛·尼加提[1] 吴长东[1] Hasiyeti·Tuerxun;XIAO Chun-hong;Aierxiding·Wusiman(First Aid Centre,Xinjiang Uygur Autonomous Region People’s Hospital,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院急救中心,新疆乌鲁木齐830001

出　　处：《医学临床研究》2021年第4期530-532,535,共4页Journal of Clinical Research

基　　金：新概维吾尔自治区自然科学基金资助项目(编号:2016D01C113)。

摘　　要：[目的]探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并右心功能不全患者6分钟步行试验(6MWT)前后心肺功能的变化。[方法]选取2019年1~12月在本院急诊科诊治的AECOPD患者60例,其中AECOPD合并右心功能不全患者30例(观察组),无右心功能不全的AECOPD患者30例(对照组)。两组患者均进行6MWT,比较6MWT测试前后心率(HR)、血压[收缩压(SBP),舒张压(DBP)].氧饱和度(SpO_(2))。[结果]观察组患者6分钟步行距离(6MWD)为(262.57±83.74)m.显著低于对照组(313.60±75.33)m.其差异有统计学意义(t=-2.48.P=0.016)。6MWT测试后HR、SBP、DBP均显著高于6MWT测试前,SpO_(2)显著低于6MWT测试前,其差异均有统计学意义(P<0.05);6MWT测试后,两组HR、DBP、SpO_(2)比较差异无统计学意义(P>0.05),观察组SBP显著高于对照组.其差异有统计学意义(t=2.142,P=0.036)。两组患者6MWT测试前后变化值(△)HR,△SBP、△SpO_(2)、△DBP比较差异均无统计学意义(P>0.05)。6MWD与SpO_(2)、△SpO_(2)、FEV1%pre、FEV1、FEV1/FVC均呈正相关(r=0.263.0.751,0.598,0.336.0.966.均P<0.05);与△SBP、△HR、PaCO_(2)均呈负相关(r=0.701.0.557,0.313,0.665.0.779.均P<0.05);与△DBP、FVC无明显相关(r=0.017.r=0.017.均P<0.05)。[结论]合并右心功能不全AECOPD患者心肺功能下降更显著,单纯6MWD可能不能更好区分运动前后心肺功能各指标的变化情况。[Objective]To investigate the changes of cardiopulmonary function before and after 6 minutes walking test(6MWT)in patients with right heart dysfunction in acute exacerbation stage of chronic obstructive pulmonary disease.[Methods]60 patients with AECOPD were selected from January to December 2019 in the e-mergency department of our hospital,ineluding 30 patients with right heart dysf unetion(observation group)and 30 patients without right cardiac insufficiency(control group).The patients in both groups were treated with 6MWT,and the heart rate(HR),blood pressure(SBP),diastolic pressure(DBP),oxygen saturation(SpO_(2))were compared before and after 6MWT,[Results]The 6 minutes walking distance(6MWD)of the observation group was(262.57±83.74)m.which was significantly lower than that of the control group(313.60±75.33)m(I=-2.48.P=0.016).After 6MWT test,HR,SBP,DBP were significantly higher than before 6MWT test.SpO_(2)was significantly lower than before 6MWT test,the differences were satistically significant(P<0.05);af-ter 6MWT test,there was no significant difference in HR,DBP,SpO_(2)between the two groups(P>0.05).SBP in the observation group was significantly higher than that in the control group,the difference was statistically significant(I=2.142.P=0.036).There was no significant difference in the change values(△HR.△SBP,△SpO_(2).ODBP)before and after 6MWT test between the two groups(P>0.05).6MWD was positively correla-ted with PaO_(2),△SpO_(2).FEV1%pre,FEV1.FEVI/FVC(r=0.263.0.751.0.598.0.336.0.966.allP<0.05);negatively correlated with△SBP,△HR,PaCO_(2)(r=0.701.0.557.0.313,0.665,0.779.all P<0.05);not significantly correlated with△DBP,FVC(r=0.017.r=0.017.all P<0.05).Conclusion]In AECOPD pa-tients with right ventricular dysfunction.the decline of cardiopulmonary function is more significant.6MWT alone may not be able to better distinguish the changes of cardiopulmonary function indexes before and after exercise.

关 键 词：肺疾病 慢性阻塞性/并发症 急性病 心力衰竭/并发症 运动试验 呼吸功能试验 心脏功能试验 

分 类 号：R563[医药卫生—呼吸系统]