继发于肺动脉高压的慢性右心衰竭与继发于左心疾病的慢性全心衰竭患者通气功能的差异

Differences of Ventilation Function in Patients Between Chronic Right Heart Failure Secondary to Pulmonary Arterial Hypertension and Chronic Whole Heart Failure Secondary to Left Heart Diseases

目的:探讨慢性右心衰竭(右心衰)与慢性全心衰竭(全心衰)的通气功能的差异。方法:102例临床稳定的慢性心力衰竭(心衰)患者入选该研究,根据心衰情况分为全心衰者(41例),右心衰者(61例)。所有患者均测定静息状态下通气功能,心肺运动试验(CPX)测定运动状态下通气功能。结果:静息状态下,全心衰者及右心衰者通气功能无差异。运动状态下,右心衰者峰值分钟通气量(peak VE)明显低于全心衰者(P<0.05),而无氧阈及峰值分钟通气量与二氧化碳(CO2)生成量比值(VE/VCO2),峰值死腔通气量与潮气量比值(peak VD/VT)高于全心衰者(P<0.05),差异均有统计学意义。结论:静息状态,全心衰者与右心衰者通气功能无差异。运动状态下,右心衰者通气功能及通气效率降低,其原因在于严重的通气血流比(V/Q)异常。

Objective： To study the differences of ventilation function in patients between chronic right heart failure secondary to pulmonary arterial hypertension and chronic whole heart failure secondary to left heart diseases.Methods： A total of 102 patients with clinical stable chronic heart failure（CHF） were studied. The patients were divided into 2 groups： Whole heart failure（WHF） group, n=41 and Right heart failure（RHF） group, n=61. The ventilation function test at rest and cardiopulmonary exercise test（CPX） were conducted and compared between 2 groups.Results： The rest ventilation function was similar between 2 groups. For CPX examination, compared with WHF group, RHF group had the lower peak minute ventilation（VE）, higher anaerobic threshold and peak minute ventilation/CO2 production（VE/VCO2）, higher peak dead space volume/tidal volume（VD/VT）, all P0.05.