短期抗凝治疗后肺栓塞患者的运动能力和通气效率。
Exercise Capacity and Ventilatory Efficiency in Patients With Pulmonary Embolism After Short Duration of Anticoagulation Therapy.
机构信息
Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China; Department of Respiratory Medicine, Wuhu Hospital of Traditional Chinese Medicine, Wuhu, China.
Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
出版信息
Am J Med Sci. 2020 Mar;359(3):140-146. doi: 10.1016/j.amjms.2019.12.011. Epub 2019 Dec 26.
BACKGROUND
Although anticoagulation therapy can reduce the risk for pulmonary embolism (PE) recurrence, symptoms such as exertional dyspnea or pain can persist for several months to years. Therefore, we aimed to assess the improvement of ventilatory efficiency and exercise capacity during cardiopulmonary exercise test in PE patients after short duration of anticoagulant therapy.
MATERIALS AND METHODS
Pulmonary function testing, arterial blood gas analysis and cardiopulmonary exercise test were performed in 30 PE patients after anticoagulant therapy of 4 weeks (early phase) and after 6 months (late phase). In addition, another 30 healthy volunteers underwent the same tests.
RESULTS
Percentage of forced vital capacity (FVC %pred) improvement was evident in the PE group (P < 0.01) after 6 months of treatment. Peak Load, peak Load %pred, peak oxygen uptake (V∘O), peak V∘O%pred increased significantly after treatment for 6 months (P < 0.01), while lowest minute ventilation in relation to carbon dioxide production (V∘E / V∘CO) and lowest V∘E / V∘CO %pred decreased significantly (P = 0.001). In PE group, the increment of peak V∘O %pred from 4 weeks to 6 months correlated with the decrease of lowest V∘E / V∘CO %pred (r = 0.639, P < 0.001) but not the increment of FVC %pred (r = 0.058, P = 0.769).
CONCLUSIONS
Exercise capacity improved significantly and there was a gradual improvement in ventilatory efficiency after 6 months of anticoagulation therapy.
背景
尽管抗凝治疗可以降低肺栓塞（PE）复发的风险，但呼吸困难或疼痛等症状可能会持续数月至数年。因此，我们旨在评估抗凝治疗 4 周后（早期）和 6 个月后（晚期）PE 患者心肺运动试验中通气效率和运动能力的改善情况。
材料和方法
对 30 例抗凝治疗 4 周后的 PE 患者（早期）和 6 个月后的 PE 患者（晚期）进行肺功能检查、动脉血气分析和心肺运动试验。此外，另外 30 名健康志愿者接受了相同的测试。
结果
治疗 6 个月后，PE 组的用力肺活量（FVC%pred）改善百分比明显（P<0.01）。治疗 6 个月后，峰值负荷、峰值负荷%pred、峰值摄氧量（V∘O）、峰值 V∘O%pred 显著增加（P<0.01），而最低分钟通气量与二氧化碳产量的比值（V∘E/V∘CO）和最低 V∘E/V∘CO%pred 显著降低（P=0.001）。PE 组中，从 4 周到 6 个月的峰值 V∘O%pred 的增加与最低 V∘E/V∘CO%pred 的降低呈显著相关（r=0.639，P<0.001），但与 FVC%pred 的增加无关（r=0.058，P=0.769）。
结论
抗凝治疗 6 个月后，运动能力显著改善，通气效率逐渐改善。
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