肺栓塞患者的摄氧效率与运动耐力的相关性 - 陈淑娟; 刘锦铭; 孙兴国 (临床与病理杂志, 2020)
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。