充血性心衰病人肺功能和呼吸肌力的测定

Determination of pulmonary function and respiratory muscle strength in patients with congestive heart failure

目的 探讨充血性心衰 (CHF)病人肺功能和呼吸肌力的变化。方法 测量CHF病人的肺通气功能、最大吸气压 (MIP)和最大呼气压 (MEP) ,以及手握力。结果 心功能Ⅲ、Ⅳ级CHF病人肺通气功能显著下降 ,用力肺活量 (FVC)、一秒率 (FEV1 0 % )、最大分钟通气量 (MVV)和用力呼气中期流速 (FEF2 5-75)分别为预测值的 6 9%、 5 7%、 49%和 30 % ,MIP和MEP较同龄对照组明显下降 (P <0 0 5 ) ,握力也下降 (P <0 0 5 ) ,而心功能Ⅱ级CHF病人上述指标趋于正常。结论 心功能Ⅲ、Ⅳ级CHF病人肺功能严重受损 ,呼吸肌力明显下降。

Objective To determine the changes of pulmonary function and respiratory muscle strength in patients with congestive heart failure(CHF).Methods Twenty patients with CHF were divided into two groups on their heart functional class.Group A consisted of 10 patients with heart functional classification class Ⅲ or Ⅳ,group B consisted of 10 patients with heart functional class Ⅱ,and group C consisted of 10 age-matched normal controls.The pulmonary function,maximal inspiratory pressure(Pimax),maximal expiratory pressure(Pemax),and maximal handgrip force were measured.Results In group A,forced vital capacity(FVC) was 69%,forced expiratory volume in 1s(FEV1) was 57%,maximal voluntary ventilation(MVV) was 49%,and forced expiratory flow between 25 and 75% of FVC(FEF25-75) was 30% of predicted value,respectively.Pimax and Pemax were significantly less than those in group C (P<0 05).Conclusion The pulmonary function and the respiratory muscle strength in patients with severe CHF was impaired significantly.