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[二尖瓣缺损患者功能能力的术前评估]

[Preoperative assessment of the functional capacity of patients with a mitral defect].

作者信息

Terzieva L

出版信息

Vutr Boles. 1986;25(3):74-85.

PMID:3765582
Abstract

The functional capacity was tested in 83 patients with mitral heart defect by step-like loading of bicycle ergometric test, making use of the indices of physical capacity for work. A complex of clinical, non-invasive and invasive investigation methods was used for the hemodynamic evaluation of the patients. A comparison was performed of the threshold power of loading with the pressure in the cardiac cavities, pulmonary artery and pulmonary capillaries, the degree of valvular stenosis, degree and duration of cardiac insufficiency, cardiac rhythm. The indices of the physical capacity for work and the pressures in the cardiac cavities were juxtaposed in the patients undergone operations and patients with postponed operations. The patients with mitral defect were established to have considerably lower indices of physical capacity for work than the healthy non-trained subjects of the same age. The correlation of threshold power of loading with the pressures in right cardiac catheterization was low. The correlation with the mean pressure in pulmonary capillaries was moderate only in the patients with mitral stenosis but--considerable (with the degree of valvular stenosis in mitral stenosis, degree of cardiac insufficiency in both patient groups and with the functional class according to NIKA)--in combined mitral defect. The patients with postponed operations had better indices of physical capacity for work and were with lower pressures, determined by right cardiac catheterization.

摘要

采用工作体力指标,通过自行车测力计试验的阶梯式负荷,对83例二尖瓣心脏缺陷患者的功能能力进行了测试。使用一系列临床、非侵入性和侵入性检查方法对患者进行血流动力学评估。将负荷阈值功率与心腔、肺动脉和肺毛细血管压力、瓣膜狭窄程度、心脏功能不全程度和持续时间、心律进行了比较。对接受手术的患者和延期手术的患者的工作体力指标和心腔压力进行了对比。结果发现,二尖瓣缺陷患者的工作体力指标明显低于同龄健康未受过训练的受试者。负荷阈值功率与右心导管检查压力的相关性较低。仅在二尖瓣狭窄患者中,与肺毛细血管平均压力的相关性中等,但在合并二尖瓣缺陷患者中相关性显著(与二尖瓣狭窄的瓣膜狭窄程度、两组患者的心脏功能不全程度以及根据纽约心脏病协会(NYHA)分级的功能分级相关)。延期手术患者的工作体力指标较好,右心导管检查测定的压力较低。

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