肺栓塞患者的摄氧效率与运动耐力的相关性
| 作者: |
1陈淑娟,
2刘锦铭,
3孙兴国
1 苏州大学附属常州市肿瘤医院(常州市第四人民医院)呼吸科，江苏 常州 213000 2 同济大学附属上海市肺科医院肺循环科，上海 200434 3 中国医学科学院/北京协和医院/国家心血管病中心/阜外心血管病医院/心血管疾病重点实验室，北京 100037 |
| 通讯: |
陈淑娟
Email: 592467296@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2020.07.014 |
| 基金: | 上海市科委临床医学科技创新重点项目(11411951302)。 |
摘要
目的：通过心肺运动试验(cardiopulmonary exercise testing，CPET)研究恢复初期肺血栓栓塞症(pulmonary thromboembolism，PE)患者的摄氧效率(oxygen uptake efficiency，OUE)与运动耐力的相关性。方法：对42例恢复初期的肺栓塞患者(PE组)和42例同年龄段健康志愿者(对照组)进行CPET和常规肺功能检测(pulmonary function test，PFT)，并测定相关的功能学指标。结果：CPET测定结果显示PE组的用力肺活量占预计值百分比(forced vital capacity as a percentage of predicted value，FVC%pred)、1秒钟用力呼气容积占预计值百分比(forced expiratory volume in 1 second as a percentage of predicted value，FEV1%pred)、一氧化碳弥散量占预计值百分比(diffusion capacity for carbon monoxide as a percentage of predicted value，DLco%pred)及肺总量占预计值百分比(total lung capacity as a percentage of predicted value，TLC%pred)均显著低于对照组[(81.03±19.82)% vs (102.36±11.14)%，(78.91±21.18)% vs (98.62±11.24)%，(83.58±21.80)% vs (108.92±23.58)%及(91.01±18.12)% vs (103.27±7.82)%，均P<0.05]。PE组的峰值摄氧量(peak oxygen uptake，peakVO2)、摄氧效率斜率(oxygen uptake efficiency slope，OUES)、摄氧效率平台(oxygen uptake efficiency plateau，OUEP)和无氧阈摄氧效率(oxygen uptake efficiency at the anaerobic threshold，OUE@AT)均显著低于健康对照组[(1 077.33±107.32) mL/min vs (1637.55±61.39) mL/min，(1.43±0.47) vs (2.03±0.44) (L/min)/lg(L/min)，(30.25±5.21) mL/L vs (35.04±4.11) mL/L，(29.27±5.74) mL/L vs (34.01±4.18) mL/L，均P<0.01]。PE组的OUES，OUEP和OUE@AT与peakVO2均呈正相关(r=0.789，r=0.676，r=0.655；均P<0.001)。结论：恢复期PE患者的OUE显著低于健康正常人，且与运动耐力呈显著相关。
关键词：
肺栓塞；心肺运动试验；摄氧效率
Correlation between oxygen uptake efficiency and exercise capacity in pulmonary thromboembolism patients
CorrespondingAuthor: CHEN Shujuan Email: 592467296@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.07.014
Foundation: This work was support by the Major Project of Clinical Medicine Initiation of Science and Technology of Shanghai Municipal Science and Technology Commission, China (11411951302).
Abstract
Objective: To explore the characteristics of oxygen uptake efficiency (OUE) in patients with pulmonary thromboembolism (PE) and analyze the correlation between OUE and exercise capacity. Methods: The relative indexes of 42 PE cases at the initial recovery stage (PE group) and 42 healthy individuals (control group) were tested using the ramp power ascending cardiopulmonary exercise testing (CPET) and pulmonary function test (PFT). Results: Compared with health control, the PE patients had lower the forced vital capacity as a percentage of predicted value (FVC%pred), forced expiratory volume in 1 second as a percentage of predicted value (FEV1%pred), diffusion capacity for carbon monoxide as a percentage of predicted value (DLco%pred) and total lung capacity as a percentage of predicted value (TLC%pred) [(81.03±19.82)% vs (102.36±11.14)%, (78.91±21.18)% vs (98.62±11.24)%, (83.58±21.80)% vs (108.92±23.58)%, and (91.01±18.12)% vs (103.27±7.82)%, all P<0.05]. The parameters of CPET in PE group, such as peak oxygen uptake (peakVO2), oxygen uptake efficiency slope (OUES), oxygen uptake efficiency plateau (OUEP) and OUE at the anaerobic threshold (OUE@AT) [(1 077.33±107.32) mL/min vs (1637.55±61.39) mL/min, (1.43 ±0.47) vs (2.03±0.44) (L/min)/lg(L/min), (30.25±5.21) mL/L vs (35.04±4.11) mL/L, (29.27±5.74) mL/L vs (34.01±4.18) mL/L, all P<0.01] were lower than those of the control group. And OUES, OUEP and OUE@AT were correlated positively with peakVO2 in PE patients (r=0.789, r=0.676, r=0.655, all P<0.001). Conclusion: The OUE significantly declines in PE patients compared with normal subjects and it is correlated positively with exercise capacity.
Keywords：
pulmonary thromboembolism; cardiopulmonary exercise testing; oxygen uptake efficiency