心力衰竭患者的呼吸肌耐力——临床严重程度的影响

Respiratory muscle endurance in heart failure--the effect of clinical severity.

作者信息

Ker J A, Schultz C M, Ker J

机构信息

Department of Internal Medicine, Pretoria Academic Hospital.

出版信息

S Afr Med J. 1998 Feb;88 Suppl 1:C20-3.

PMID:9542491

Abstract

UNLABELLED

In chronic heart failure there is no single explanation for reduced effort tolerance. Recently, abnormalities of skeletal muscles, which include respiratory muscles, have been described in cases of chronic heart failure. The aim of this study was to investigate the effect of clinical severity of heart failure, measured by means of the Boston score, on respiratory muscle performance (strength and endurance).

METHODS

Using the Boston score, we compared 20 patients with chronic heart failure and low ejection fraction to 20 normal people, measuring maximal inspiratory mouth pressures (MIPs), maximal expiratory mouth pressures (MEPs) and endurance. Endurance was measured by repeated maximal static contractions of MIP and MEP as well as maximal voluntary ventilation (MVV).

RESULTS

Inspiratory strength (MIP 75 +/- 34 cmH2O) but not expiratory strength (MEP 116.9 +/- 43.7 cmH2O) were reduced in heart failure patients, compared with controls (MIP 96.2 +/- 29.2, MEP 120.4 +/- 31 cmH2O). Endurance of inspiratory muscles was significantly reduced (P < 0.007) but not of expiratory muscles (P > 0.25). Clinical severity did not correlate with reduced endurance.

CONCLUSION

Endurance of the inspiratory muscles was reduced in chronic heart failure unrelated to clinical severity.

摘要

未标注

在慢性心力衰竭中，对于运动耐力降低没有单一的解释。最近，在慢性心力衰竭病例中已描述了包括呼吸肌在内的骨骼肌异常。本研究的目的是通过波士顿评分来研究心力衰竭临床严重程度对呼吸肌功能（力量和耐力）的影响。

方法

我们使用波士顿评分，将20例慢性心力衰竭且射血分数低的患者与20名正常人进行比较，测量最大吸气口腔压力（MIP）、最大呼气口腔压力（MEP）和耐力。耐力通过MIP和MEP的重复最大静态收缩以及最大自主通气量（MVV）来测量。

结果

与对照组（MIP 96.2±29.2，MEP 120.4±31 cmH₂O）相比，心力衰竭患者的吸气力量（MIP 75±34 cmH₂O）降低，但呼气力量（MEP 116.9±43.7 cmH₂O）未降低。吸气肌的耐力显著降低（P<0.007），但呼气肌的耐力未降低（P>0.25）。临床严重程度与耐力降低无关。