文章摘要
陈雪松,宫素岗,袁 萍,王 岚,刘锦铭,解卫平.心肺运动试验在慢性阻塞性肺疾病相关性肺动脉高压评估中的作用[J].南京医科大学学报,2021,(4):522~527
心肺运动试验在慢性阻塞性肺疾病相关性肺动脉高压评估中的作用
Role of cardiopulmonary exercise testing in evaluating of chronic obstructive pulmonary disease related pulmonary hypertension
投稿时间:2020-08-17  
DOI:10.7655/NYDXBNS20210408
中文关键词: 慢性阻塞性肺疾病  肺动脉高压  心肺运动试验  无创评估
英文关键词: chronic obstructive pulmonary disease  pulmonary hypertension  cardiopulmonary exercise testing  noninvasive evaluation
基金项目:江苏省卫生计生委科研课题(H201601)
作者单位
陈雪松 南京医科大学第一附属医院呼吸与危重症医学科江苏 南京 210029 
宫素岗 同济大学附属上海市肺科医院肺循环科上海 200433 
袁 萍 同济大学附属上海市肺科医院肺循环科上海 200433 
王 岚 同济大学附属上海市肺科医院肺循环科上海 200433 
刘锦铭 同济大学附属上海市肺科医院肺循环科上海 200433 
解卫平 南京医科大学第一附属医院呼吸与危重症医学科江苏 南京 210029 
摘要点击次数: 530
全文下载次数: 303
中文摘要:
      目的:通过比较慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)相关性肺动脉高压(pulmonary hypertension,PH)患者及COPD无PH患者在心肺运动试验(cardiopulmonary exercise testing,CPET)中气体交换及运动耐量的差异,探索CPET在COPD相关性PH无创评估中的作用。方法:94例稳定期COPD患者根据右心导管平均肺动脉压分为COPD?nonPH组、COPD?PH组、COPD?严重PH组,分别进行常规肺功能及CPET检查。结果:相较于COPD?nonPH,在发生PH后一氧化碳弥散量明显下降[(46.5 ± 21.8)% vs. (64.6 ± 34.0)%,P < 0.05]。COPD?PH组峰值功率、峰值摄氧量占预计值百分比、峰值公斤摄氧量、峰值氧脉搏及摄氧效率斜率均低于COPD?nonPH组,且随PH严重程度进一步降低,差异均有统计学意义(P < 0.05)。COPD?PH组通气效率最低点高于COPD?nonPH组,且随PH严重程度明显升高(49.0 ± 24.6 vs. 38.6 ± 11.4 vs. 35.6 ± 9.6,P < 0.05)。峰值心率、呼吸交换率、摄氧效率平台、潮气末二氧化碳分压在各组间差异无统计学意义(P > 0.05)。结论:相较于COPD?nonPH患者,COPD?PH患者气体交换和运动耐量显著下降,且随PH严重程度进一步加重,CPET可以作为COPD相关性PH病情严重程度无创评估的有效工具。
英文摘要:
      Objective:To explore the role of cardiopulmonary exercise testing(CPET)in noninvasive evaluation of chronic obstructive pulmonary disease(COPD)related pulmonary hypertension(PH)by comparing the differences of gas exchange and exercise tolerance in CPET between patients with COPD related PH and patients without PH. Method:A total of 94 stable COPD patients were divided into COPD?nonPH group,COPD?PH group,COPD?severe PH group according to mean pulmonary artery pressure measured by right heart catheterization. All patients underwent routine lung function testing and CPET. Result:Compared with COPD?nonPH,diffusing lung capacity for carbon monoxide(DLCO)decreased significantly after PH occurred[(46.5 ± 21.8)% vs.(64.6 ± 34.0)%,P < 0.05]. Peak load,peak VO2% pred,peak VO2/kg,peak O2 pulse,and oxygen uptake efficiency slop(OUES)in COPD?PH group were lower than those in COPD?nonPH group,and further decreased with PH severity,there were statistically significant differences(P < 0.05). The ventilatory equivalents for CO2 nadir(VE/VCO2 nadir)in COPD?PH group was higher than that in COPD?nonPH group,and increased significantly in severe PH group(49.0 ± 24.6 vs. 38.6 ± 11.4 vs. 35.6 ± 9.6,P < 0.05). Other outcomes such as peak heart rate,respiratory exchange rate(RER),oxygen uptake efficiency platform(OUEP),and peak end?tidal CO2 partial pressure(PetCO2) showed no significant differences among the three groups(P > 0.05). Conclusion:Compared with COPD?nonPH patients,gas exchange and exercise tolerance significantly decreased in COPD?PH patients,and further deteriorated with the severity of PH. CPET could be used as an effective tool for noninvasive evaluation of COPD related PH.
查看全文   查看/发表评论  下载PDF阅读器