【摘要】：【目的】通過心肺運(yùn)動(dòng)試驗(yàn)（cardiopulmonary exercise testing,CPET），研究恢復(fù)期肺栓塞（pulmonary thromboembolism, PTE）患者的運(yùn)動(dòng)耐力、通氣有效性和攝氧效率，分析相關(guān)參數(shù)在運(yùn)動(dòng)中的變化趨勢和反應(yīng)特點(diǎn)。 【方法】對50例恢復(fù)初期肺栓塞患者和50例同年齡段健康志愿者進(jìn)行斜坡式功率遞增癥狀限制性極限CPET、常規(guī)肺功能檢測（PFT）及動(dòng)脈血?dú)夥治觯╝rterial bloodgas analysis, ABG），測定相關(guān)的人體功能學(xué)檢測參數(shù)。 【結(jié)果】（1）與正常人相比，PTE患者的峰值功率（peakLoad）、峰值攝氧量（peak（V|·）O_2）和OUEP、OUES和OUE@AT均明顯降低，而（V|·）E/（V|·）CO_2@AT、（V|·）E/（V|·）CO_2-slope和Lowest（V|·）E/（V|·）CO_2則明顯升高。（2）在靜息期、熱身期、無氧閾和峰值運(yùn)動(dòng)時(shí)PTE患者的（V|·）O_2、（V|·）E/（V|·）CO_2、潮氣末二氧化碳分壓（PETCO_2）和（V|·）O_2/（V|·）E與正常人相比均具有顯著統(tǒng)計(jì)學(xué)差異（p0.001），且兩組間各參數(shù)在運(yùn)動(dòng)中的變化趨勢和反應(yīng)特點(diǎn)亦不相同。從靜息期至峰值運(yùn)動(dòng)時(shí)，正常人的（V|·）O_2逐漸升高，但PTE患者（V|·）O_2的遞增速率則明顯降低；正常人的（V|·）E/（V|·）CO_2隨功率的遞增逐漸降低，，AT時(shí)降至最低，直到通氣代償點(diǎn)之后又開始升高，而PTE患者的（V|·）E/（V|·）CO_2一直處于較高水平；從靜息期至AT正常人的PETCO_2逐漸上升，至AT時(shí)達(dá)到最大值，而后逐漸下降，但是PTE患者的PETCO_2始終保持低值；正常人的（V|·）O_2/（V|·）E隨功率的遞增先上升后下降，AT時(shí)達(dá)到最大值，而PTE患者的（V|·）O_2/（V|·）E從靜息期至AT無明顯變化，AT之后開始下降，但無統(tǒng)計(jì)學(xué)差異。(3)PTE患者的Lowest（V|·）E/（V|·）CO_2與一氧化碳彌散量占預(yù)計(jì)值的百分比（DLCO%pred）呈顯著負(fù)相關(guān)（分別為r=-0.753, p0.001），而peakPETCO_2與DLCO%pred呈明顯正相關(guān)（r=0.655,p0.01）。OUES、 OUEP和OUE@AT與DLCO%pred均有顯著相關(guān)性（分別為r=0.683,0.505,0.491; p0.001,0.01,0.01） 【結(jié)論】恢復(fù)初期肺栓塞患者的其運(yùn)動(dòng)耐力、通氣有效性及攝氧效率都是降低的，各相關(guān)參數(shù)在CPET中的變化趨勢和反應(yīng)特點(diǎn)與正常人明顯不同，且與DLCO%pred具有很好的相關(guān)性，為肺栓塞患者的臨床療效評(píng)估及抗凝時(shí)間窗的選擇提供了重要的參考依據(jù)。
[Abstract]:[Objective] To study the movement endurance, ventilation effectiveness and oxygen uptake efficiency of patients with pulmonary embolism (PTE) in the recovery period through cardiopulmonary exercise (CPET). [Methods] 50 patients with initial pulmonary embolism and 50 healthy volunteers of the same age group were subjected to ramp-type power-increasing symptom-limiting CPET, conventional pulmonary function test (PFT) and arterial blood gas analysis (ABG). [Results] (1) The peak power (peak load), peak oxygen uptake (peak (V | 路) O _ 2) and OEP, OUES, and OUE@AT of PTE patients were significantly lower than that of normal persons, and (V | 路) E/ (V | 路) CO_2@AT, (V | 路) E/ (V | 路) CO _ 2-slope and Lowest (V | 路) E/ (V | 路) CO _ 2 were clear. (2) In resting period, warm-up period, oxygen-free threshold and peak exercise, the (V | 路) O _ 2, (V | 路) E/ (V | 路) CO _ 2, the end-tidal carbon dioxide partial pressure (PETCO _ 2) and (V | 路) O _ 2/ (V | 路) E of the patients had significant statistical difference (p0.001), and the change tendency and the reaction characteristics of the parameters in the exercise were not the same. From the rest period to the peak exercise, the (V | 路) O _ 2 of the normal person was gradually increased, but the increasing rate of the (V | 路) O _ 2 in the normal person was decreased gradually. The (V | 路) E/ (V | 路) CO _ 2 of the normal person was gradually decreased with the increase of the power, and the (V | 路) E/ (V | 路) CO _ 2 of the patient started to rise after the ventilation compensation point, and the (V |.) E/ (V |.) After the AT, the maximum value was reached, while the (V | 路) O _ 2/ (V | 路) E in the PTE patients had no significant change from the rest period to the AT, and the AT began to decrease after the AT, but no statistics (3) There was a significant negative correlation between (V | 路) E/ (V | 路) CO _ 2 and carbon monoxide dispersion in PTE (r =-0.753, p0.001), while peakPETCO _ 2 was positively correlated with DLCO% pred (r = 0.655, p0). 01). The OUES, OUEP and OUE @ ATs have a significant correlation with DLCO% pred (r = 0.683, 0.505, 0.491; p0.001, 0.01,0, respectively) (.01)[Conclusion] The exercise endurance, the effectiveness of the ventilation and the oxygen uptake efficiency of the patients with the initial pulmonary embolism are reduced. The trend and the response characteristics of the relevant parameters in the CPET are obviously different from that of the normal person, and the correlation with the DLCO% pred is very good, and it is important for the evaluation of the clinical curative effect of the patients with pulmonary embolism and the selection of the anti-coagulation time window.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R563.5

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相關(guān)期刊論文 前2條

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