脑卒中偏瘫患者心肺运动功能评估临床研究

A clinical study on cardiopulmonary exercise testing in people with hemiplegia after stroke

目的:评估脑卒中后偏瘫患者心肺运动功能,了解偏瘫患者心肺功能储备能力,探寻脑卒中偏瘫患者有氧运动康复方案。方法:选取11例脑卒中后偏瘫患者(实验组)和11例健康志愿者(对照组)进行心肺运动实验测试,比较两组受试对象心肺运动实验各指标差异。结果:两组受试对象性别、年龄、体重指数等基础指标差异无显著性。实验组峰值摄氧量(13.1±3.2 vs 22.3±6.6ml/kg/min)、无氧阈(11.2±2.9 vs 15.5±3.6ml/kg/min)、能量代谢当量(3.7±0.9 vs 6.4±1.9)、峰值氧脉搏(7.7±2.0 vs11.2±2.5ml)、峰值呼吸交换率(0.98±0.08 vs 1.15±0.11)、峰值分钟通气量(30.9±8.5 vs 55.7±17.7L/min)、峰值功率(72.5±18.8 vs 118.8±46.8w)与最大心率(117.9±14.7 vs 135.1±20.4bpm)明显低于对照组(P<0.05),静息心率(81.6±11.5 vs 72.5±4.9bpm)明显高于对照组(P<0.05)。实验组静息血压与峰值血压与对照组比较无显著性差异(P>0.05)。结论:脑卒中偏瘫患者心肺运动功能明显低于健康人,心肺储备功能下降,脑卒中偏瘫患者的康复过程中有必要给予一定强度的有氧运动,以改善心肺运动功能,预防卒中再发和提高运动功能。

Objective： The aim of this study was to evaluate cardiorespiratory fitness and cardiopulmonary reserve function, establish aerobic exercise rehabilitation program in people with hemiplegia after stroke. Method： Eleven individuals with hemiplegia after stroke （the observation group） and eleven healthy volunteers （age and gender-matched adults, the control group） were given cardiopulmonary exercise t-testing （CPET）. We used independent t tests to determine the differences of the cardiopulmonary performance between two groups. Result： No significant differences were found in age, gender and body mass index （BMI） between two groups. The observation group had significantly lower values （P〈0.05） for peak oxygen uptake （VO2peak, 13.1±3.2 vs 22.3±6.6ml/kg/min）, anaerobic threshold （AT, 11.2±2.9 vs 15.5±3.6ml/kg/min）, metabolic equivalent of energy （MET, 3.7±0.9 vs 6.4±1.9）, peak oxygen pulse （VO2/HR, 7.7±2.0 vs 11.2±2.5ml）, peak respiratory rate of exchange （RER=VCO2/VO2, 0.98±0.08 vs 1.15±0.11）, minute ventilation （VE, 30.9±8.5 vs 55.7±17.7L/min）, peak power （WRpeak, 72.5±18.8 vs 118.8±46.8w） and peak heart rate （HRpeak, 117.9±14.7 vs 135.1±20.4bpm）,when compared with the control group. The observation group had significantly higher values （P〈 0.05） for resting heart rate （HRrest, 81.6±11.5 vs 72.5±4.9bpm） than the control group. There were no significant differences in resting blood pressure and peak blood pressure between two groups （P 〉 0.05）. Conclusion： These results suggest that cardiorespiratory fitness and cardiopulmonary reserve function in people with hemiplegia after stroke was lower than those of the healthy people. Aerobic exercise in stroke was beneficial for improving cardiovascular health, reducing cardiac risk and improving physical performance in rehabilitation program.