《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (07): 668-670.

• 临床研究 • 上一篇    下一篇

摄氧效率斜率：评价成人心肺功能储备的新指标

李寿霖1,2;孟申1,2;陈思远1,2;张焱1,2;雒生杰1,2;刘杰1,2   

  1. 1.首都医科大学康复医学院，北京市 100068; 2.中国康复研究中心北京博爱医院内科，北京市 100068
  • 收稿日期:2009-04-16 出版日期:2009-07-01 发布日期:2009-07-01

Oxygen Uptake Efficiency Slope： A New Index of Cardiopulmonary Functional Reserve for Adults

LI Shou-lin,MENG shen,CHEN Si-yuan,et al   

  1. Department of Internal Medicine, Capital Medical University School of Rehabilitation Medicine, Beijing Charity Hospital, China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2009-04-16 Published:2009-07-01 Online:2009-07-01

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摘要： 目的 探讨摄氧效率斜率（OUES）作为评价成人心肺功能储备指标的应用价值。方法 对33名健康成人和31例心脏病患者采用症状限制性标准Bruce分级平板运动方案，同时测定摄氧量（VO2）、CO2排出量（VCO2）、峰值VO2、每分通气量(VE)、呼吸气体交换率(RER)。采用对数曲线拟合的方法，分析递增负荷运动试验中VO2与VE之间的关系，建立回归方程VO2=alog10VE+b，计算75%、90%、100%运动期间时的a值为75%OUES、90%OUES、100%OUES。同时测定无氧阈（VAT）和VAT点的CO2通气当量（VE/VCO2 at VAT）。结果 100%OUES、90%OUES和75%OUES平均值无显著性差异（F=0.212，P=0.809），75%OUES仅比100%OUES降低1.9%。100%OUES（r=0.836）、90%OUES（r=0.824）和75%OUES（r=0.777）均与峰值VO2呈显著正相关（均P<0.001）。VAT与峰值VO2呈显著正相关（r=0.878，P<0.001），而VE/VCO2 at VAT与峰值VO2呈显著负相关（r=-0.584，P<0.001）。100%OUES与90%OUES（r=0.991）、75%OUES（r=0.945）均呈显著正相关（P<0.001）。结论 OUES可以作为评价健康成人及心脏病患者的心肺储备功能的指标，而且75%OUES能够反映患者的心肺储备功能，为在亚极量运动水平评价心肺功能提供有价值的指标。

关键词: 摄氧效率斜率, 健康成人, 心脏疾病, 心肺运动试验

Abstract: Objective To investigate the efficacy of the oxygen uptake efficiency slope (OUES), obtained from submaximal exercise, as an index of cardiopulmonary functional reserve in adults. Methods Exercise tests, following a symptom-limited standard Bruce protocol with simultaneous respiratory gas measurement, were performed on a treadmill in 33 healthy adults free of clinically recognized cardiovascular disease and 31 patients with heart disease. The OUES was derived from the relation between oxygen uptake (VO2) and minute ventilation (VE) during incremental exercise and was determined by VO2=alog10VE+b, where a=OUES. The OUES was calculated from data of the first 75%, 90% and 100% of exercise duration (as 75%OUES，90%OUES and 100%OUES). Results The 100%OUES，90%OUES and 75%OUES were not significantly different from each other（F=0.212，P=0.809）. The 75%OUES was slightly lower (1.9%) than the 100%OUES. The 100%OUES, the 90%OUES and the 75%OUES correlated with the peak VO2 （r=0.836,r=0.824 and r=0.777, P<0.001, respectively）. The VAT correlated with the peak VO2 （r=0.878，P<0.001），and the VE/VCO2 at VAT correlated with the peak VO2 （r=-0.584，P<0.001）. The 100%OUES correlated with the 90%OUES and the 75%OUES （r=0.991 and r =0.945, P<0.001, respectively）. Conclusion The OUES is an index of exercise performance and cardiopulmonary functional reserve on healthy adults and patients with cardiac disease. The 75%OUES from submaximal exercise can be an index of cardiopulmonary functional reserve for patients with cardiac disease.

Key words: oxygen uptake efficiency slope, healthy adult, cardiac diseases, cardiopulmonary exercise test