心肺运动试验对慢性阻塞性肺疾病患者肺功能的评估价值研究.pdf

GP军酸医景
http:/uowre.chinggp.netE-mail:agqhr@chinagp.net507
专题研究
心肺运动试验对慢性阻塞性肺疾病患者肺功能的
评估价值研究
桂珍珍,夏岑峰,高艳,王绍金,张鹏,张锦
摘要』目的探讨心肺运动试验(CPET)评估慢性阻塞性肺疾病(COPD)患者肺功能的特点以及与常规肺
功能检査(PT)评估的一致性。方法选取2014年1-9月在守复医科大学总医院门诊就诊的稳定期COPD患者26
例为试验组,同期体检健康志愿者29例为对照组。两组均行PT及CPET,记录相关参数并进行比较,且分析PFT与
CPET评估COPD患者肺功能的吻合性。结果PFT结果显示,两组用力肺活量(FVC)间差异无统计学意义(P
0.05);而试验组第1秒用力呼气末容积(FEV1)、FEV占预计值百分比(FEV1%pred)、FEV/FVC均低于对照组,
差异有统计学意义(P<0.05)。CPET检査结果显示,两组峰值运动时CO2输出量( peak VCO2)、无氧阈(AT)时
CO2通气当量(VE/VCO2)间差异均无统计学意义(P>0.05);而试验组峰值功率(Wmax)、峰值摄氧量
( peakvo2)、峰值公斤摄氧量( peakvo2/kg)、 peakvo2占预计值百分比( peak VO2%pred)、AT、最大心率( Hrmax)
氧脉搏(O2/ Hrmax)、最大分钟通气量( Vemax)、呼吸储备( BRMAX)均低于对照组,运动前后血氧饱和度(SaO2)
差值高于对照组,差异有统计学意义(P<0.05)。PFT与CPT评估COPD患者肺功能严重程度分布间差异有统计学
意义(=3.290,P=0.001)。26例患者中,有8例(30.8%)患者两种评估方法分级一致;16例(61.5%)患者
CPET评估的肺功能损害程度较PFT严重;PFT评估为重度和极重度的10例患者中,仅有2例与CPET评估分级不
致。结论CPET在COPD患者肺功能早期诊断中较静态肺功能灵敏。
【关键词】肺疾病,慢性阻塞性;心肺运动试验;肺功能
【中图分类号】R563【文献标识码)Adoi:10.3969/1isn.1007-9572.2016.05.003
桂珍珍,夏岑峰,高燕,等,心肺运动试验对慢性阻塞性肺疾病患者肺功能的评估价值研究[J].中国全科医
学,2016,19(5):507-510,520.[w. chinagp-net
Gui ZZ, Xia CF, Gao Y, et al. Value of cardiopulmonary exercise test in the evaluation of the pulmonary function of
patients with chronic obstructive pulmonary disease I J]. Chinese General Practice, 2016, 19(5): 507-510, 520
Value of Cardiopulmonary Exercise Test in the Evaluation of the Pulmonary Function of Patients With Chronic
Obstructive Pulmonary Disease GU Zhen-zhen, XIA Cen-feng, GAO Yan, et al. Respiratory and Critical Discipline of
Ningia Medical University General Hospital, Yinchuan 750004, China
Abstract] Objective To investigate the features of cardiopulmonary exercise test(CPET) in the evaluation of the
pulmonary function of patients with chronic obstructive pulmonary disease(COPD) and its consistency with conventional
pulmonary function test (PT)in the evaluation of pulmonary function of COPD patients. Methods We enrolled 26 patients
who were at the stable period of COPD and received treatment in the outpatient department of Ningxia Medical University General
Hospital from January to September in 2014. We also enrolled 29 healthy volunteers who received physical examinations in the
same period. PFT and CPET were conducted on both groups, and relevant parameters were recorded and compared between the
two groups. The consistency between PFT and CPET in the assessment of the lung function of COPD patients was analyzed
Results The result of PFT showed that the two groups were not significantly different in forced vital capacity(FVC)(P
0.05); the trial group was lower than control group in FEV FEV% pred and FEV /FVC(P<0. 05 for all). The result of
CPET showed that the two groups were not significantly diferent in peak VCO and VE/VCO (P>0. 05 for all ); trial group was
lower in Wmax, peakvo2 peakvo /kg, peak VO pred, AT, Hrmax, O /Hrmax, Vemax and Brmax and was higher in
Sa0 before and after exercise than control group (P<0. 5 for all); there were significant differences between PFT and CPET in
the assessment of the distribution of lung function abnormality severity(u=. 290, P=0.001).Among the 26 patients, there
作者单位:75000宇夏回族自治区银川市,宁夏医科大学总医院呼吸与危重症医学科
通信作者:张锦,750004宁夏回族自治区银川市,宁夏医科大学总医院呼吸与危重症医学科;E-mail:jinzhangnew@hotmail.com