摘要
目的：以心肺运动试验（CPET）评估慢性血栓栓塞性肺动脉高压（CTEPH）患者接受肺动脉高压靶向药物治疗后运动能力有无改善。方法2011年1月至2014年5月在阜外医院心内科肺血管病房住院的14例CTEPH患者，接受肺动脉靶向药物治疗3～12个月，治疗前后均进行CPET评估其运动能力。结果 CTEPH患者接受靶向药物治疗3～12个月后峰值氧耗量和氧脉搏均有明显改善（P＜0.05）；潮气末肺泡二氧化碳分压明显增加（P＜0.001）；分钟通气量/二氧化碳排出量（VE/VCO2）斜率及VE/VCO2最低值均显著下降（P＜0.05）。但世界卫生组织功能分级较治疗前无明显改变（P＞0.05）；超声心动图检测右心室舒张末期内径及其与左心室舒张末期内径之比、肺动脉收缩压无明显差异（P＞0.05）；N端脑钠肽前体水平在治疗前后无显著性差异（P＞0.05）。结论 CPET是评估CTEPH患者肺动脉高压靶向药物治疗后运动耐力的良好工具。
Objective To investigate the value of cardiopulmonary exercise testing （CPET） in the evaluation of the motor function improvement in the patients with chronic thromboembolic pulmonary hypertension （CTEPH） after targeted therapeutic drugs. Methods Fourteen CTEPH patients admitted to the Center for Pulmonary Vascular Diseases, Fuwai Hospital from January 2011 to May 2014 were enrolled in this study. They all received targeted drug therapy for 3 to 12 months. CPET was employed to evaluate their motor functions before and after the treatment. Results Significant improvements were observed in peak oxygen consumption （peak VO2）, oxygen consumption/heart rate peak （VO2/HR peak）, along with remarkably reduced minute ventilation volume/CO2 production （VE/VCO2） slope, the lowest VE/VCO2 ratio, and the increased levels of end-tidal partial pressure of CO2 （PetCO2） after 3 to 12 months＇ treatment with targeted drug therapy for pulmonary arterial hypertension （PAH）. But there was no obvious change in WHO function class, right ventricular end-diastolic diameter and its ratio to left ventricular end-diastolic diameter, pulmonary artery systolic pressure, and the levels of N-terminal pro-brain natriuretic peptide （NT-proBNP）. Conclusion CPET is a promising approach to evaluate the efficiency of targeted drug therapy for CTEPH patients.
出处
《中华老年多器官疾病杂志》
2015年第3期165-168,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
心肺运动试验
慢性血栓栓塞性肺动脉高压
靶向药物治疗
cardiopulmonary exercise testing
chronic thromboembolic pulmonary hypertension
targeted drug therapy
作者简介
通信作者：柳志红，E—mail：liuzhihong@fuwai．com
