六分钟步行距离试验在鉴别肺高血压血流动力学类型中的价值

The clinical value of six-minute walk test in identifying pulmonary patients hypertension combined with or without heart dysfunction

目的 探讨6 min步行距离试验在鉴别肺高血压血流动力学类型中的意义.方法 收集164例心功能Ⅱ～Ⅲ级初诊肺高血压患者的临床资料进行回顾性分析.根据肺高压血流动力学指标及右心功能状况分为A组（毛细血管前肺动脉高压、右心功能正常,62例）、B组（毛细血管后肺动脉高压、右心功能正常,58例）、C组（毛细血管前肺动脉高压合并右心功能不全,44例）,主要分析指标为6 min步行距离及运动前后动脉血氧饱和度.结果 A组、B组和C组6 min步行距离分别为（397±112）、（ 299±63）和（294±111）m,A组明显高于B组和C组,组间差异有统计学意义（P＜0.01）；B组与C组间比较差异无统计学意义（P＞0.05）.结论 肺高血压合并心功能不全6 min步行距离明显减少；但单独6 min步行距离检查不能区分血流动力学类型.

Objective To compare the variation of 6-minute walk distance in patents with pulmonary hyper- tension combined with or without heart dysfunction, and to assess its value in identifying heart dysfunction classification. Methods Totally 164 pulmonary hypertension patients with United States New York Heart Association （NY- HA） Ⅱ～Ⅲ class who received a right heart catheter and an echocardiography exam were divided into 3 groups. Group A contained 62 patients who had post-capillary pulmonary hypertension without right heart insufficiency. Group B contained 58 patients who had pre-capillary pulmonary hypertension without right heart insufficiency. Group C contained 44 patients who had pre-eapillary pulmonary hypertension companied with right heart insufficiency. 6-minute walk tests were carried out in these patients and the results were analyzed. Results There were significant differ- ences in the results of 6-minute walk distance among three groups （397 ±112 meters in Group A, 299±63 meters in Group B, and 294 ±111 meter in Group C） （P 〈0. 01 ）. There were no differences in 6-minute walk distance between group B and group C （ P 〉 0.05 ）. Conclusions 6-minute walk distance is significantly reduced in pulmo- nary hypertension patients with heart dysfunction. However, it can not identify left heart insufficiency and right heart insufficiency.