CAJ | 학술논문

目的研究心肺运动试验(CPET)相关指标在心肌缺血患者诊断中的价值。方法 52例胸痛患者患者分别行CPET、99Tcm-MIBI心肌灌注显像检查及心脏彩色多普勒超声检查。根据心肌灌注显像检查结果分为心肌缺血组（30例）及非缺血组（22例）。比较2组患者的CPET相关指标如每千克体重峰摄氧量( VO2 peak/kg)、峰摄氧最(VO2 peak)、峰氧脉搏(VO2 peak/HR)、最大呼吸频率、氧斜率、呼吸储备、最大心率、心率储备和无氧阈、无氧阈时氧气通气当最、无氧阈时二氧化碳通气当量、无氧阈时氧脉搏以及心脏彩色多普勒超声检查二尖瓣口血流舒张早期峰值速度(E)与舒张晚期峰值速度(A)的比值（E/A值）和左心室射血分数(LVEF)。结果 2组患者之间年龄、性别、BMI、E/A值及EF值差异均无统计学意义。心肌缺血组与非缺血组比较、VO2 peak/kg[(27±6) ml/(kg·min)比(33±7)ml/(kg·min)，P＜0.01]，vO2 peak[(1.5±0.5) L/min比(2.1±0.5) L/min，P＜0.01]、VO2 peak/HR[(10.7±2.6) ml/次比(14.1±3.0)ml/次，P＜0.01]、最大心率[(143±15)次/min比(154±17)次/min，P＜0.05]和无氧阈[(16.4±3.0)ml/(kg·min)比(20.6±5.0)ml/(kg·min)，P＜0.01]、无氧阈时氧脉搏[(9.0±1.8)ml/次比(11.3±2.3) ml/次，P＜0.01]均明显为低，差异具有统计学意义。结论采用心肺运动试验检测心肌缺血患者的VO2 peak/kg、VO2 peak、VO2 peak/HR、无氧阚和无氧阈时氧脉搏等指标对早期发现心肌缺血具有一定价值。
목적 연구심폐운동시험(CPET)상관지표재심기결혈환자진단중적개치。방법 52례흉통환자환자분별행CPET、99Tcm-MIBI심기관주현상검사급심장채색다보륵초성검사。근거심기관주현상검사결과분위심기결혈조（30례）급비결혈조（22례）。비교2조환자적CPET상관지표여매천극체중봉섭양량( VO2 peak/kg)、봉섭양최(VO2 peak)、봉양맥박(VO2 peak/HR)、최대호흡빈솔、양사솔、호흡저비、최대심솔、심솔저비화무양역、무양역시양기통기당최、무양역시이양화탄통기당량、무양역시양맥박이급심장채색다보륵초성검사이첨판구혈류서장조기봉치속도(E)여서장만기봉치속도(A)적비치（E/A치）화좌심실사혈분수(LVEF)。결과 2조환자지간년령、성별、BMI、E/A치급EF치차이균무통계학의의。심기결혈조여비결혈조비교、VO2 peak/kg[(27±6) ml/(kg·min)비(33±7)ml/(kg·min)，P＜0.01]，vO2 peak[(1.5±0.5) L/min비(2.1±0.5) L/min，P＜0.01]、VO2 peak/HR[(10.7±2.6) ml/차비(14.1±3.0)ml/차，P＜0.01]、최대심솔[(143±15)차/min비(154±17)차/min，P＜0.05]화무양역[(16.4±3.0)ml/(kg·min)비(20.6±5.0)ml/(kg·min)，P＜0.01]、무양역시양맥박[(9.0±1.8)ml/차비(11.3±2.3) ml/차，P＜0.01]균명현위저，차이구유통계학의의。결론 채용심폐운동시험검측심기결혈환자적VO2 peak/kg、VO2 peak、VO2 peak/HR、무양감화무양역시양맥박등지표대조기발현심기결혈구유일정개치。
Objective To investigate the value of cardiopulmonary exercise testing in patients with myocardial ischemia. Methods Fifty-two patients with chest pain were divided into two groups according the results of 99Tcm-MIBI stress-rest perfusion imaging: ischemia group and non- ischemia group. All patients received cardiopulmonary exercise testing and noninvasive echocardiography. The differences of cardiopulmonary exercise testing data were evaluated. Results No significant difference in age, gender, body weight index, E/A and EF between two groups. Compared to non-ischemia group, VO2 peak/kg[(27 ±6)ml/(kg · min) vs (33 ±7)ml/(kg · min) ,P＜0.01], VO2 peak[(1.5 ±0.5)L/min vs (2.1 ±0.5)L/min,P＜0.01],VO2 peak/HR[(10.7 ±2.6) ml/beat vs (14.1 ±3.0)ml/beat,P ＜0.01],HR[(143 ± 15)beats/min vs (154 ± 17)beats/min,P ＜0.05]and AT[(16.4 ±3. 0) ml/( kg · min) vs ( 20.6 ± 5. 0) ml/( kg · min) , P ＜ 0. 01], VO2 peak/HR @ AT in eardiopulmonary exercise [(9.0 ± 1.8) m l/beat vs (11.3 ±2.3) ml/beat, P ＜0.01]in ischemia group were significant decreased.Conclusion VO2 peak/Kg, VO2 peak, VO2peak/HR, AT and VO2/HR @ AT have potential value in early discovery of myocardial ischemia.