运动负荷气体交换法评价心肺功能的研究及临床应用

Research and Clinical Application of Exercise Load Gas Exchange in Evaluation of Heart and Lung Function

运动心肺功能试检能够较早地从疾病进程中鉴别出呼吸困难的原因,而且对于潜在危险的心肺疾病的患者,也可以用通过运动实验的方法导致病人的呼困,以此来鉴别潜在呼困的原发疾病,并予以早期治疗。本文从运动生理学的实验研究过渡到临床应用,针对心肺专科特点,摸索出一整套以无创性运动负荷气体交换学来评估心肺功能的方法、方案,建立健康组及疾病组的生理及病生理参数。健康组180例优化出10项多元回归预计方程,疾病组80例(风心30例、慢阻肺20例、肺纤维化30例),归纳出限制运动的功能特征。首次将风心病按国际标准-代谢当量(MET)进行心功能分级,把无氧阈(AT)的概念由运动医学引用到临床医学,将资料归纳为作功量最大值、无氧阈三方面进行综合判断。

Exercise tests have been more widly applied in the investigation of cardiac andpulmonary disorders.In order to find out a series of systematic methods using non-invasive gas exchange methods from the experimental studies of exercise physiology,180 healthy subjects(90 males,and 90 females) were selected who had an even distri-bution of age (20～60) in five groups.A progressively incremental exercise test mea-surement of (?)O_2 (?)CO_2 (?)E heart rate and blood pressure,etc,was made,with 10regressive equations relating to sex,age,height and weight.Dyspnea during exertioncould be caused by either cardiac or pulmonary disease.To outline the charactesisticsof cardiogenie dyspnea and pulmonary dyspnea during exertion incremental exercisetesting was performed in 30 patients with rheumatic mitral valve disease,30 withdiffused interstital-pulmonary fibrosis and 20 with COPD.It was the first time to useMet (metabolic equivaleut) to evaluate the cardiac function in MVD in this countryand turn the concept of anaerobic threshold (AT) form exercise physiology to clini-cal application.The complicated determination depended upon the total workrate,maximal value and anaerobic threshold.