Ambrosino N, Bruschi C, Callegari G, Baiocchi S, Felicetti G, Fracchia C, Rampulla C
Salvatore Maugeri Foundation IRCCS, Medical Center, Montescano, Italy.
Eur Respir J. 1996 Jul;9(7):1508-14. doi: 10.1183/09031936.96.09071508.
Recipients of heart-lung transplantation (HLT) show reduced exercise capacity due to several pre- and postsurgical factors. The aim of this study was to evaluate the time course of exercise capacity, and skeletal and respiratory muscle performance in 11 patients (5 females and 6 males; age (mean +/- SD) 38 +/- 13 yrs) undergoing HLT. All of the patients were admitted to our institution for a rehabilitation programme after surgery, and were followed-up for 18 months. On admission, at discharge after an in-patient rehabilitation programme, and every 6 months, patients underwent evaluation of: lung function values; incremental treadmill exercise, 6 min walking distance (6-MWD); maximal inspiratory and expiratory pressures (MIP and MEP, respectively); and peak torque of isokinetic contraction of leg flexor and extensor muscles (IFX and IEX, respectively). On admission, patients had: reduced lung volumes as assessed by vital capacity (VC) (60 +/- 15% of predicted); reduced exercise capacity as assessed by peak oxygen consumption (V'O2,peak) (40 +/- 12% pred); reduced skeletal and respiratory muscle performance as assessed by IEX, IFX (48 +/- 16 and 28 +/- 12 Newton-metres (N x m), respectively) and by MIP and MEP (54 +/- 21 and 58 +/- 19 cmH2O, respectively). Ten patients completed the rehabilitation programme. At discharge, no significant change in dynamic and static lung volumes was observed. However, nonsignificant increases in MIP, MEP, IEX, IFX, 6-MWD and V'O2,peak were recorded. After 6 and 12 months, indices of skeletal and respiratory muscle function and V'O2, peak improved further, but still remained lower than normal values. We conclude that in patients with heart-lung transplantation, skeletal and respiratory muscle function and exercise performance are reduced after surgery, that they may improve with time but are still less than normal after 18 months.
心肺移植（HLT）受者由于术前和术后的多种因素，运动能力下降。本研究的目的是评估11例接受HLT的患者（5名女性和6名男性；年龄（平均±标准差）38±13岁）的运动能力、骨骼肌和呼吸肌功能随时间的变化情况。所有患者术后均入住我院接受康复计划，并随访18个月。入院时、住院康复计划出院时以及每6个月，患者接受以下评估：肺功能值；递增式平板运动、6分钟步行距离（6-MWD）；最大吸气和呼气压力（分别为MIP和MEP）；以及腿部屈肌和伸肌等速收缩的峰值扭矩（分别为IFX和IEX）。入院时，患者有：通过肺活量（VC）评估的肺容积减少（为预测值的60±15%）；通过峰值耗氧量（V'O2,peak）评估的运动能力下降（为预测值的40±12%）；通过IEX、IFX（分别为48±16和28±12牛顿米（N x m））以及MIP和MEP（分别为54±21和58±19 cmH2O）评估的骨骼肌和呼吸肌功能下降。10例患者完成了康复计划。出院时，动态和静态肺容积未观察到显著变化。然而，MIP、MEP、IEX、IFX、6-MWD和V'O2,peak有不显著的增加。6个月和12个月后，骨骼肌和呼吸肌功能指标以及V'O2峰值进一步改善，但仍低于正常值。我们得出结论，心肺移植患者术后骨骼肌和呼吸肌功能以及运动表现下降，它们可能随时间改善，但18个月后仍低于正常水平。
