非紫绀型先天性心脏病儿童的心肺运动耐力研究

Cardiopulmonary exercise tolerance of children with acyanotic congenital heart disease

目的 明确非紫绀型先天性心脏病儿童的心肺耐力状况。方法 收集175例4~18岁非紫绀型先天性心脏病儿童(先天性心脏病组)的相关临床资料,对儿童身高、体质量、体质量指数(body mass index,BMI)等生长发育指标及经6 min步行试验(six-minute walk test, 6MWT)评估的心肺运动耐力结果进行回顾性分析,以年龄、性别匹配的377名健康儿童作为正常对照组。结果 6MWT评估结果显示:先天性心脏病组平均步行距离(520.0 m)显著低于正常对照组(590.0 m),差异有统计学意义(P<0.001);试验前后,两组儿童心率、呼吸频率、血压、血氧饱和度等指标均在正常范围内,运动过程中儿童对运动的生理反应也均在正常范围内,无不良事件发生。先天性心脏病组生长发育指标显著落后于正常对照组,差异均有统计学意义(P身高=0.022,P体质量=0.002,PBMI=0.003)。结论 6MWT可用于非紫绀型先天性心脏病儿童心肺运动耐力评估,此型先天性心脏病的心肺运动耐力低于同龄健康儿童。

Objective To evaluate the cardiorespiratory exercise tolerance of children with acyanotic congenital heart disease(CHD). Methods Relevant clinical data of 175 children aged 4-18 years with acyanotic CHD(CHD group) were collected. The children’s height, weight, body mass index(BMI) and other growth and development indicators and the results of cardiorespiratory exercise tolerance assessed by the six-minute walk test(6MWT) were retrospectively analyzed, with 377 age-and sex-matched healthy children as the normal control group(NC group). Results The 6MWT results showed that the average walking distance(520.0m) in the CHD group was significantly shorter than that in the NC group(590.0m)(P<0.001). In both groups, the heart rate, breath frequency, blood pressure, and blood oxygen saturation were all within the normal range pre-and post-test, and the children’s physiological response to exercise was also within the normal range. No adverse events occurred. The growth and development indexes of the CHD group were significantly lower than those of the NC group(P=0.022, P=0.002, P=0.003). Conclusion The 6MWT is a reliable test which can be used as a practical tool for assessing the cardiorespiratory exercise tolerance of children with acyanotic CHD, and also this population have lower cardiorespiratory exercise tolerance than healthy children.