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中国早中期帕金森病患者心肺适能的评估

Assessment of cardiorespiratory fitness in Chinese patients with early to mid-stage Parkinson's disease.

作者信息

Wang Kaili, Cheng Hao, Yang Bo, Liu Dan, Maria Maria, Wu Qiong, Qiao Jin

机构信息

Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China.

Department of Rehabilitation Medicine and Physiotherapy, School of Clinical Medicine, Xi'an Jiaotong University, Shaanxi, China.

出版信息

Int J Neurosci. 2024 Jul 16:1-10. doi: 10.1080/00207454.2024.2377140.

Abstract

PURPOSE

To evaluate cardiorespiratory fitness in patients with early to mid-stage Parkinson's disease by cardiopulmonary exercise test (CPET) on a stationary cycle ergometer.

METHODS

To compare the differences in each index of the cardiopulmonary exercise test between the two groups of subjects; general data such as disease duration, medication use and exercise habits were also collected.

RESULTS

(1) Finally, 36 Parkinson's disease patients and 12 healthy controls successfully completed the cardiopulmonary exercise test without any adverse events. (2) The V'Opeak, Metspeak, RERpeak, MVVpeak, Wpeak, HRpeak, HRpeak/pre, percentage of HRR-1 min decay > 12 bpm, SBPpeak in the Parkinson's disease group were lower than those in the control group ( < .05, each). Detailed data: V'O2peak (15.7 ± 4.5vs21.5 ± 3.6 ml/kg/min,  < .01), Metspeak (4.5 ± 1.3 vs 6.1 ± 1.0,  < .01), RERpeak (1.04 ± 0.10 vs 1.15 ± 0.10,  = .001), MVVpeak (37.22 ± 11.58 vs 53.00 ± 16.85L/min,  = .009), Wpeak (49.17 ± 29.72 vs 49.17 ± 29.72W,  < .01), HRpeak (111.08 ± 16.67 vs 111.08 ± 16.67bpm,  < .01), HRpeak/pre (71.19 ± 10.06 vs 96.00 ± 21.13,  = .002), percentage of HRR-1min decay > 12bpm (33.3% vs 100%,  < .01), systolic blood pressure (155.81 ± 31.83 vs 175.83 ± 17.84 mmHg,  = .01). (3) Divided Parkinson's disease patients into high V'Opeak group (V'Opeak ≥ 15 mL/kg/min) and low V'Opeak group (V'Opeak < 15 mL/kg/min). The age of patients, Hoehn-Yahr grade and incidence of symptom fluctuation in high V'Opeak group were lower ( < .05, respectively), percentage of males and percentage of HRR-1 min decay > 12 bpm were higher ( < .05, respectively);  < .05 is considered a statistically significant difference. Detailed data: age of patients(61.05 ± 6.93 vs 68.57 ± 7.99 years,  = .005), Hoehn-Yahr grade(1.75 ± 0.48 vs 2.18 ± 0.64,  = .028), incidence of symptom fluctuation (59.1 vs 92.9%,  = .03), percentage of males (77.7 vs 42.9%,  = .041), percentage of HRR-1 min decay > 12 bpm (50 vs 7.1%,  = .008).

CONCLUSIONS

Cardiopulmonary exercise test was safe to perform and the cardiorespiratory fitness is significantly reduced in patients with early and middle stage Parkinson's disease. Patients with Parkinson's disease presented blunted heart rate and systolic blood pressure responses to exercise test. Females, older age, fluctuating symptoms, high H-Y staging and higher activities of daily living may be associated with lower oxygen uptake.

摘要

目的

通过在固定自行车测力计上进行心肺运动试验(CPET),评估早中期帕金森病患者的心肺适能。

方法

比较两组受试者心肺运动试验各指标的差异;同时收集病程、用药情况及运动习惯等一般资料。

结果

(1)最终,36例帕金森病患者和12名健康对照成功完成心肺运动试验,无任何不良事件。(2)帕金森病组的峰值摄氧量(V'Opeak)、代谢当量峰值(Metspeak)、呼吸交换率峰值(RERpeak)、最大分钟通气量峰值(MVVpeak)、峰值功率(Wpeak)、心率峰值(HRpeak)、运动前心率峰值(HRpeak/pre)、心率储备-1分钟下降>12次/分钟的百分比、收缩压峰值(SBPpeak)均低于对照组(均P<0.05)。详细数据:V'O2peak(15.7±4.5对21.5±3.6ml/kg/min,P<0.01),Metspeak(4.5±1.3对6.1±1.0,P<0.01),RERpeak(1.04±0.10对1.15±0.10,P = 0.001),MVVpeak(37.22±11.58对53.00±16.85L/min,P = 0.009),Wpeak(49.17±29.72对49.17±29.72W,P<0.01),HRpeak(111.08±16.67对111.08±16.67次/分钟,P<0.01),HRpeak/pre(71.19±10.06对96.00±21.13,P = 0.002),心率储备-1分钟下降>12次/分钟的百分比(33.3%对100%,P<0.01),收缩压(155.81±31.83对175.83±17.84mmHg,P = 0.01)。(3)将帕金森病患者分为高V'Opeak组(V'Opeak≥15ml/kg/min)和低V'Opeak组(V'Opeak<15ml/kg/min)。高V'Opeak组患者年龄、Hoehn-Yahr分级及症状波动发生率较低(分别P<0.05),男性百分比及心率储备-1分钟下降>12次/分钟的百分比更高(分别P<0.05);P<0.05被认为具有统计学显著差异。详细数据:患者年龄(61.05±6.93对68.57±7.99岁,P = 0.005),Hoehn-Yahr分级(1.75±0.48对2.18±0.64,P = 0.028),症状波动发生率(59.1对92.9%,P = 0.03),男性百分比(77.7对42.9%,P = 0.041),心率储备-1分钟下降>12次/分钟的百分比(50对7.1%,P = 0.008)。

结论

心肺运动试验实施安全,早中期帕金森病患者的心肺适能显著降低。帕金森病患者在运动试验中心率和收缩压反应迟钝。女性、年龄较大、症状波动、高H-Y分期及较高的日常生活活动能力可能与较低的摄氧量有关。

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