目的 定量评估脊髓损伤患者心肺运动功能，探讨有氧运动对脊髓损伤患者心肺功能、运动功能及日常功能的影响。方法 选取2014年12月至2016年6月本科34例不完全性脊髓损伤患者(ASIA C级和D级)，另取23例正常对照者作为对照组，进行心肺运动试验测试。患者随机分成常规康复组(n=17)和有氧运动组(n=17)，有氧运动组接受有氧运动训练4周。评估训练前后患者进行心肺运动试验、ASIA运动和感觉评分、脊髓损伤步行指数Ⅱ(WISCIⅡ)和脊髓功能性独立评分(SCIM)。结果 脊髓损伤患者峰值摄氧量(VO2peak)、无氧阈(AT)、峰值能量代谢当量(METpeak)、峰值氧脉搏(VO2/HRpeak)、峰值呼吸交换率(RERpeak)、峰值分钟通气量(VEpeak)、峰值功率(WRpeak)、峰值收缩压(SBPpeak)较对照组降低(t>2.714, P<0.05)。有氧运动组4周训练后VO2peak、AT、METpeak、VO2/HRpeak、WRpeak较训练前改善(t>2.431, P<0.05)。常规康复组4周训练后METpeak和WRpeak较治疗前明显改善(t>3.282, P<0.01)。两组患者训练4周后ASIA运动评分和SCIM评分较前明显改善(t>2.985, P<0.01)。结论 不完全性脊髓损伤患者心肺功能下降，给予中等强度的有氧运动，可有效改善心肺储备功能。
Objective To quantitatively assess the cardiopulmonary exercise function of spinal cord injury (SCI) patients and observe the effect of aerobic exercise on cardiopulmonary function, motor function and activities of daily living. Methods From December, 2014 to June, 2016, 34 incomplete SCI patients (ASIA C and D) and 23 healthy controls received cardiopulmonary exercise test (CPET). SCI patients were randomly divided into conventional rehabilitation group (n=17) and aerobic exercise group (n=17). The aerobic exercise group received aerobic exercise for four weeks. They were assessed with CPET, motor and sensory function, walking index for spinal cord injury II(WISCI II) and spinal cord independence measure (SCIM) before and four weeks after training. Results Oxygen uptake (VO2)peak, anaerobic threshold (AT), metabolic equivalent of energy (METpeak), VO2/heart rate (HR)peak, respiratory exchange rate (RER)peak, minute ventilation (VE)peak, work rate (WR)peak and systolic blood pressure (SBP)peak were lower in the patients than in the controls (t>2.714, P<0.05). VO2peak、AT、METpeak、VO2/HRpeak、WRpeak increased in the aerobic exercise group after training (t>2.431, P<0.05). METpeak and WRpeak improved in the conventional rehabilitation group after training (t>3.282, P<0.01). The scores of motor in ASIA and SCIM improved in both groups after training (t>2.985, P<0.05). Conclusion The cardiopulmonary function decreased in incomplete SCI patients, which could be improved by moderate intensity aerobic exercise.
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