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化疗后白血病患者的心肺运动试验:一项可行性研究

Cardiopulmonary Exercise Test in Leukemia Patients After Chemotherapy: A Feasibility Study.

作者信息

Kim Soojae, Song Ik-Chan, Jee Sungju

机构信息

Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.

Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.

出版信息

Ann Rehabil Med. 2017 Jun;41(3):456-464. doi: 10.5535/arm.2017.41.3.456. Epub 2017 Jun 29.

Abstract

OBJECTIVE

To explore the feasibility of cardiopulmonary exercise test (CPET) in leukemia patients after chemotherapy.

METHODS

Leukemia patients with histologically confirmed hematologic malignancies were reviewed. We evaluated for CPET, between receiving chemotherapy and undergoing stem cell transplantation after 2 weeks. We recorded exercise testing and physiologic parameters during CPET between January 2013 to May 2015. All patients were subjected to symptoms limited to exercise testing, according to the Modified Bruce Protocol. We considered that if respiratory exchange ratio achieved was over 1.10, participants had successfully completed CPET. We dichotomized all participants into two groups (normal group, normal range of resting heart rate; higher group, over 100 per minute of heart rate).

RESULTS

30 patients were finally enrolled. All participants had no adverse effects during the exercise test. Mean peak double product was 26,998.60 mmHg·beats/min (range, 15,481-41,004), and mean peak oxygen consumption (VO peak) was 22.52±4.56 mL/kg/min. Significant differences were observed in the normal group with VO peak (mean, 24.21 mL/kg/min; p=0.027) and number of prior intensive chemotherapy, compared to the higher group (mean, 1.95; p=0.006).

CONCLUSION

Our results indicate that CPET in leukemia patients before stem cell transplantation was very safe, and is an efficient method to screen for patients with poor cardiac functions. As CPET presents the parameters which reveal the cardiopulmonary functions, including VO peak, double product and exercise capacity, this exercise test would help to predict the physical performance or general condition of the leukemia patients.

摘要

目的

探讨心肺运动试验(CPET)在白血病患者化疗后的可行性。

方法

回顾组织学确诊的血液系统恶性肿瘤白血病患者。在接受化疗后2周且进行干细胞移植前,对患者进行CPET评估。记录2013年1月至2015年5月期间CPET过程中的运动测试和生理参数。所有患者均按照改良布鲁斯方案进行症状受限的运动测试。若呼吸交换率达到1.10以上,则认为参与者成功完成CPET。将所有参与者分为两组(正常组,静息心率在正常范围;较高组,心率每分钟超过100次)。

结果

最终纳入30例患者。所有参与者在运动测试期间均未出现不良反应。平均峰值心率血压乘积为26,998.60 mmHg·次/分钟(范围为15,481 - 41,004),平均峰值耗氧量(VO峰值)为22.52±4.56 mL/kg/分钟。与较高组相比,正常组在VO峰值(平均值为24.21 mL/kg/分钟;p = 0.027)和既往强化化疗次数方面存在显著差异(平均值为1.95;p = 0.006)。

结论

我们的结果表明,干细胞移植前白血病患者进行CPET非常安全,是筛查心功能不良患者的有效方法。由于CPET呈现出揭示心肺功能的参数,包括VO峰值、心率血压乘积和运动能力,这项运动测试将有助于预测白血病患者的身体表现或总体状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac6f/5532352/1a2d043ba6f3/arm-41-456-g001.jpg

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