纵隔疾病患者运动心肺功能特点研究

发布时间：2018-06-16 18:00

本文选题：纵隔疾病 + 运动心肺功能　；参考：《中国全科医学》2017年36期

【摘要】：目的探讨纵隔疾病患者运动心肺功能的特点及其可能的影响因素。方法回顾性选取2014年11月—2016年11月于首都医科大学附属北京胸科医院住院的符合纳入标准的纵隔疾病患者44例为病例组,选取同期于本院住院的静息心电图、静息肺功能正常及心电图运动试验阴性的非纵隔疾病患者32例为对照组。按病变周围有无血管受侵,将病例组分为有血管受侵亚组(34例)和无血管受侵亚组(10例)。根据病变部位,将病例组分为前纵隔亚组(34例)和中、后纵隔亚组(10例)。记录患者静息心电图检查、静息肺功能检查、心肺运动试验(CPET)相应观察指标。结果所有患者静息心电图呈窦性心律,无缺血性ST-T段改变。病例组肺活量占预计值百分比(VC%)低于对照组,残气量/肺总量(RV/TLC)、总气道阻力占预计值百分比(R_5%)高于对照组(P0.05)。病例组运动负荷占预计值百分比(W%)、最大摄氧量占预计值百分比(VO_2%)、氧脉搏占预计值百分比(VO_2/HR%)、呼气潮气容积(VTex)、潮气容积/肺活量(VT/VC)、血氧饱和度(SpO_2)低于对照组,呼吸频率(BF)高于对照组(P0.05)。中、后纵隔亚组W%、呼吸储备(BR)高于前纵隔亚组,呼吸困难指数(DI)低于前纵隔亚组(P0.05)。有血管受侵亚组W%低于无血管受侵亚组(P0.05)。结论纵隔疾病患者运动耐力、运动心功能、运动肺功能均下降。患者的静息肺功能、纵隔病变部位及血管受侵可能对其运动心肺功能有一定影响。
[Abstract]:Objective to investigate the characteristics of cardiopulmonary function in patients with mediastinal diseases and its possible influencing factors. Methods 44 patients with mediastinal diseases who were hospitalized in Beijing chest Hospital affiliated to Capital Medical University from November 2014 to November 2016 were retrospectively selected as the case group. 32 patients with normal resting lung function and negative electrocardiogram exercise test were the control group. According to the presence of vascular invasion around the lesion, the patients were divided into two groups: 34 patients with vascular invasion and 10 patients with no vascular invasion. According to the lesion location, the patients were divided into anterior mediastinal subgroup (34 cases) and middle mediastinal subgroup (10 cases) and posterior mediastinal subgroup (10 cases). The resting electrocardiogram (ECG), resting pulmonary function and cardiopulmonary exercise test (CPETs) were recorded. Results all patients showed sinus rhythm and no ischemic ST-T segment changes. The percentage of vital capacity to predicted value in the case group was lower than that of the control group, and the residual volume / total lung volume was higher than that of the control group, and the percentage of total airway resistance to the predicted value was R5) higher than that of the control group (P 0.05). In the case group, the percentage of exercise load to the predicted value, the percentage of maximal oxygen uptake to the predicted value, the percentage of oxygen pulse to the predicted value, the percentage of oxygen pulse to the predicted value, the volume of expiratory tidal volume and VTextam, the volume of tidal volume / vital capacity, VT / VCU, and the oxygen saturation of SPO _ 2 were lower than those of the control group. The respiratory frequency (BF) was higher than that in the control group (P 0.05). In the middle, posterior mediastinal subgroup, the BRR of the respiratory reserve was higher than that of the anterior mediastinal subgroup, and the dyspnea index (DII) was lower than that of the anterior mediastinal subgroup (P0.05). W% in the subgroup with vascular invasion was lower than that in the subgroup without vascular invasion (P 0.05). Conclusion exercise endurance, exercise heart function and exercise lung function in patients with mediastinal diseases are all decreased. The resting pulmonary function, mediastinal lesion site and vascular invasion may have some effects on the exercise cardiopulmonary function.
【作者单位】：首都医科大学附属北京胸科医院心肺功能室;
【分类号】：R564

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