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[儿童、青少年及成人先天性心脏缺陷患者的心肺功能]

[Cardiopulmonary capacity of patients with congenital heart defects in childhood, adolescence and adulthood].

作者信息

Fritsch J, Winter U J, Kaemmerer H, Hilger H H

机构信息

Klinik III für Innere Medizin, Universität zu Köln.

出版信息

Z Kardiol. 1994;83 Suppl 3:131-9.

PMID:7941660
Abstract

Cardiopulmonary exercise capacity is a significant criterion of life quality. The evaluation of the exercise capacity is important to answer patient-questions concerning every day activity, choice of profession, sports-activity etc. We performed cardiopulmonary exercise testing in 38 patients (age 33.6 +/- 12.0 years, 18 women, 20 men) with different congenital heart disease (5 after surgical repair of tetralogy of fallot, 2 after Mustard-operation in transposition of the great arteries (TGA), 1 single ventricle, 14 atrial septal defect (ASD), 8 ventricular septal defect (VSD), 8 pulmonary valve stenosis (PS)) during outpatient routine control. All tests were performed on upright bicycle with continuous ramp program of 20 Watt increase/minute. Ventilatory values as O2-uptake, CO2-production, minute ventilation (VE) were measured breath-by-breath. Max. VO2 was reduced as average value for every patient group (tetralogy of fallot 60.2 +/- 20.3% pred., TGA 53.0 +/- 0.0% pred., single ventricle 35% pred., closed ASD 71.9 +/- 23.8% pred., ASD 62.7 +/- 30.0% pred., VSD 64.1 +/- 11.7% pred., PS 73.2 +/- 16.0% pred.). Anaerobic threshold was reduced in tetralogy of fallot (35.9 +/- 12.2% pred. max. VO2) and in single ventricle (28.3% pred. max. VO2). In comparison with clinical classification of exercise capacity we found for max. VO2 differences in 23/38 patients. 22/23 patients reported no exercise limitation but had reduced max. VO2. One patient had a normal max. VO 2 but complaints of exercise dyspnoea. For anaerobic threshold 18/38 patients had discrepancies in objective and subjective estimation of their exercise capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

心肺运动能力是生活质量的一项重要指标。运动能力评估对于解答患者关于日常活动、职业选择、体育活动等问题至关重要。我们对38例(年龄33.6±12.0岁,女性18例,男性20例)患有不同先天性心脏病的患者进行了心肺运动测试(5例法洛四联症术后、2例大动脉转位(TGA)Mustard手术后、1例单心室、14例房间隔缺损(ASD)、8例室间隔缺损(VSD)、8例肺动脉瓣狭窄(PS)),测试在门诊常规检查期间进行。所有测试均在直立式自行车上进行,采用每分钟增加20瓦的连续递增程序。逐次测量通气值,如氧气摄取量、二氧化碳产生量、分钟通气量(VE)。每个患者组的最大摄氧量(Max. VO2)均降低(法洛四联症60.2±20.3%预计值,TGA 53.0±0.0%预计值,单心室35%预计值,闭合性ASD 71.9±23.8%预计值,ASD 62.7±30.0%预计值,VSD 64.1±11.7%预计值,PS 73.2±16.0%预计值)。法洛四联症(35.9±12.2%预计最大摄氧量)和单心室(28.3%预计最大摄氧量)的无氧阈值降低。与运动能力的临床分类相比,我们发现38例患者中有23例的最大摄氧量存在差异。22/23例患者报告无运动受限,但最大摄氧量降低。1例患者最大摄氧量正常,但有运动性呼吸困难主诉。对于无氧阈值,38例患者中有18例在运动能力的客观和主观评估上存在差异。(摘要截选至250字)

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