中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
44期
3104-3107
,共4页
心力衰竭%心肺运动试验%超声心动图
心力衰竭%心肺運動試驗%超聲心動圖
심력쇠갈%심폐운동시험%초성심동도
Heart failure%Cardiopulmonary exercise test%Ultrasonic cardiogram
目的 探索心肺运动试验(CPET)应用于评估射血分数正常心力衰竭(HFNEF)患者病情及预后的价值.方法 2010年9月至2012年7月,在杭州市第一人民医院住院的心力衰竭患者中抽取49例HFNEF,NYHA分级为Ⅱ级的患者.于入院后第3天行CPET及心脏多普勒超声(UCG)检查.采用Person相关分析及偏相关分析研究CPET与UCG各项指标间相关性.结果 CPET与UCG指标存在一定相关性.其中二尖瓣口舒张早期血流峰值/二尖瓣环舒张早期运动速度(E/E’,10.14 ±2.05)与峰值摄氧量[VO2peak,(24.15 ±8.31)ml·kg-1·min-1,r=-0.287,P=0.046]、二氧化碳排出量[VCO2,(1.63±0.51) L/min,r=-0.429,P=0.002]、通气末二氧化碳分压[PET CO2,(39.50±7.77) mm Hg,r=-0.282,P=0.050]呈负相关,与二氧化碳通气斜率(VE/VCO2,31.69±5.32)呈正相关(r=0.411,P=0.003).二尖瓣环舒张早期运动速度[E’,(6.46±1.60) cm/s]与VO2 peak(r=0.351,P=0.013)、VCO2(r=0.452,P=0.001)、PET CO2(r=0.310,P=0.030)、呼吸交换率(RER,1.18±0.13,r=0.350,P=0.014)呈正相关,与VE/VCO2呈负相关(r=-0.434,P=0.002).偏相关校正后显示,VCO2与E/E’(r=-0.369,P=0.019)及E’(r=0.393,P=0.010)相关,VE/VCO2与E/E'(r=0.414,P=0.006)及E'(r=-0.334,P=0.031)相关.结论 CPET应用于HFNFE患者,有较高的预后评估价值.
目的 探索心肺運動試驗(CPET)應用于評估射血分數正常心力衰竭(HFNEF)患者病情及預後的價值.方法 2010年9月至2012年7月,在杭州市第一人民醫院住院的心力衰竭患者中抽取49例HFNEF,NYHA分級為Ⅱ級的患者.于入院後第3天行CPET及心髒多普勒超聲(UCG)檢查.採用Person相關分析及偏相關分析研究CPET與UCG各項指標間相關性.結果 CPET與UCG指標存在一定相關性.其中二尖瓣口舒張早期血流峰值/二尖瓣環舒張早期運動速度(E/E’,10.14 ±2.05)與峰值攝氧量[VO2peak,(24.15 ±8.31)ml·kg-1·min-1,r=-0.287,P=0.046]、二氧化碳排齣量[VCO2,(1.63±0.51) L/min,r=-0.429,P=0.002]、通氣末二氧化碳分壓[PET CO2,(39.50±7.77) mm Hg,r=-0.282,P=0.050]呈負相關,與二氧化碳通氣斜率(VE/VCO2,31.69±5.32)呈正相關(r=0.411,P=0.003).二尖瓣環舒張早期運動速度[E’,(6.46±1.60) cm/s]與VO2 peak(r=0.351,P=0.013)、VCO2(r=0.452,P=0.001)、PET CO2(r=0.310,P=0.030)、呼吸交換率(RER,1.18±0.13,r=0.350,P=0.014)呈正相關,與VE/VCO2呈負相關(r=-0.434,P=0.002).偏相關校正後顯示,VCO2與E/E’(r=-0.369,P=0.019)及E’(r=0.393,P=0.010)相關,VE/VCO2與E/E'(r=0.414,P=0.006)及E'(r=-0.334,P=0.031)相關.結論 CPET應用于HFNFE患者,有較高的預後評估價值.
목적 탐색심폐운동시험(CPET)응용우평고사혈분수정상심력쇠갈(HFNEF)환자병정급예후적개치.방법 2010년9월지2012년7월,재항주시제일인민의원주원적심력쇠갈환자중추취49례HFNEF,NYHA분급위Ⅱ급적환자.우입원후제3천행CPET급심장다보륵초성(UCG)검사.채용Person상관분석급편상관분석연구CPET여UCG각항지표간상관성.결과 CPET여UCG지표존재일정상관성.기중이첨판구서장조기혈류봉치/이첨판배서장조기운동속도(E/E’,10.14 ±2.05)여봉치섭양량[VO2peak,(24.15 ±8.31)ml·kg-1·min-1,r=-0.287,P=0.046]、이양화탄배출량[VCO2,(1.63±0.51) L/min,r=-0.429,P=0.002]、통기말이양화탄분압[PET CO2,(39.50±7.77) mm Hg,r=-0.282,P=0.050]정부상관,여이양화탄통기사솔(VE/VCO2,31.69±5.32)정정상관(r=0.411,P=0.003).이첨판배서장조기운동속도[E’,(6.46±1.60) cm/s]여VO2 peak(r=0.351,P=0.013)、VCO2(r=0.452,P=0.001)、PET CO2(r=0.310,P=0.030)、호흡교환솔(RER,1.18±0.13,r=0.350,P=0.014)정정상관,여VE/VCO2정부상관(r=-0.434,P=0.002).편상관교정후현시,VCO2여E/E’(r=-0.369,P=0.019)급E’(r=0.393,P=0.010)상관,VE/VCO2여E/E'(r=0.414,P=0.006)급E'(r=-0.334,P=0.031)상관.결론 CPET응용우HFNFE환자,유교고적예후평고개치.
Objective To assess the clinical and predictive value of cardiopulmonary exercise testing (CPET) used in heart failure with normal left ventricular ejection fraction (HFNEF).Methods A total of 49 HFNEF patients of (New York Heart Association) NYHA class Ⅱ were randomly selected from September 2010 to July 2012.The parameters of CPET and ultrasonic cardiogram (UCG) were collected at Day 3 post-admission.Person's and partial correlations were used to perform to compare CPET and UCG.Results Pearson's correlation revealed that mitral peak velocity of early filling/early diastolic mitral annular velocity(E/E',10.14 ± 2.05) was significantly correlated with peak oxygen uptake (VO2 peak,(24.15 ±8.31)ml · kg-1 · min-1,r =-0.287,P =0.046),carbon dioxide production (VCO2,(1.63 ±0.51)L/min,r =-0.429,P =0.002),partial pressure of end-tidal carbon dioxide (PET CO2,(39.50 ±7.77) mm Hg,r =-0.282,P =0.050) and minute ventilation/carbon dioxide production (VE/VCO2,31.69 ± 5.32,r =0.411,P =0.003).Early diastolic mitral annular velocity (E',(6.46 ± 1.60) cm/s)was relevant to VO2 peak (r =0.351,P =0.013),VCO2 (r =0.452,P =0.001),PET CO2 (r =0.310,P =0.030),VE/VCO2 (r =-0.434,P =0.002) and respiratory exchange ratio (RER,1.18 ± 0.13,r =0.350,P =0.014).After adjustment,VCO2 was correlated with E/E' (r =-0.369,P =0.019) and E'(r =0.393,P =0.010).VE/VCO2 was relevant to E/E' (r =0.414,P =0.006) and E' (r =-0.334,P =0.031).Conclusion For HFNFE patients,CPET has high values of assessment and prognosis.
