基于心肺运动试验的脑卒中偏瘫患者心肺适能的特征

doi:10.3969/j.issn.1006-9771.2025.04.009

Abstract

Abstract:

Objective To analyze the characteristics in heart, lung and skeletal muscles of patients with post-stroke hemiplegia, and explore the main contributors to the cardiorespiratory fitness (CRF) after stroke with cardiopulmonary exercise testing (CPET).
Methods From December, 2021 to July, 2023, 79 eligible stroke patients with hemiplegia were recruited from Shanghai Jing'an District Central Hospital; meanwhile, twelve age- and gender-matched healthy subjects were recruited as controls. All the subjects received CPET. Paired-samples t test or Wilcoxon signed rank test was used to compare the differences of the CPET derived parameters between twelve stroke patients and healthy subjects. Multiple linear regression was used to analyze the main contributors to the CRF of stroke patients with hemiplegia.
Results The peak oxygen uptake (VO₂peak), anaerobic threshold (AT)/VO₂peak%pred (∣t∣ > 7.027, P < 0.001), and O₂pulse peak (Z = -2.433, P < 0.05) were lower, and the volume of dead space (VD)/tidal volume (VTpeak) was higher in the patients than in the controls (t = 4.217, P < 0.01). Multiple linear regression analysis indicated that O₂ pulse peak (B = 0.461) and AT/VO₂peak%pred (B = 19.340) were the main contributors to the VO₂peak of stroke patients with hemiplegia (P < 0.01) after the removal of the interference of age, and AT/VO₂peak%pred was the largest contributor.
Conclusion The CRF of hemiplegic patients after stroke has decreased, especially for the output volume, the efficiency of gas exchange and aerobic capacity of skeletal muscles. Skeletal muscle aerobic capacity and cardiac blood-pumping function are the main contributors to the CRF, especially the aerobic capacity of skeletal muscles.

Key words: stroke, cardiorespiratory fitness, cardiopulmonary exercise test, exercise tolerance

CLC Number:

R743.3

CHEN Mengye, QU Qingming, ZHU Jie, CHEN Xianggui, JIA Jie. Characteristics of cardiorespiratory fitness in patients with post-stroke hemiplegia based on cardiopulmonary exercise testing[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 441-447.

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References 25

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配对编号	对照组			试验组
配对编号	编号	性别	年龄/岁	编号	性别	年龄/岁
1	C1	女	27	E1	女	27
2	C2	男	39	E2	男	42
3	C3	男	44	E3	男	45
4	C4	女	52	E4	女	53
5	C5	男	69	E5	男	74
6	C6	女	76	E6	女	76
7	C7	男	68	E7	男	66
8	C8	男	67	E8	男	62
9	C9	女	57	E9	女	58
10	C10	男	61	E10	男	60
11	C11	女	47	E11	女	40
12	C12	女	67	E12	女	73

组别	n	年龄/岁	身高/cm	体质量/kg	BMI/(kg·m^-2 )
对照组	12	56.17±14.62	163.58±6.82	63.04±11.71	23.39±2.93
试验组	12	56.33±15.35	165.67±9.59	65.42±11.60	23.72±2.58
t值		0.155	1.208	0.960	0.395
P值		0.879	0.253	0.358	0.700

组别	n	VO₂peak/ (ml·kg^-1·min^-1)	O₂ pulse peak/ (ml·beat^-1)	VEpeak/MVV	VD/VTpeak	AT/VO₂peak%pred/%
对照组	12	22.00±5.10	10.03±2.69	0.50±0.21	0.11±0.08	76.02±15.66
试验组	12	13.19±4.07	6.97±2.65	0.45±0.22	0.27±0.15	38.05±16.19
t/Z值		-7.027	-2.433	-0.537	4.217	-7.670
P值		< 0.001^a	0.015^b	0.602^a	0.001^a	< 0.001^a

变量	VO₂peak
变量	B	t值	P值
性别^a	—	0.639	0.525
年龄^b	-0.161	-3.767	< 0.001
身高^b	-0.079	-0.869	0.388
体质量^b	-0.032	-0.495	0.622
BMI^b	-0.037	-0.145	0.885

变量	B	SE	β	t值	P值	95%CI
常量	14.873	1.768	—	8.411	< 0.001	11.408~18.339
年龄	-0.203	0.024	-0.496	-8.474	< 0.001	-0.249~-0.156
O₂ pulse peak	0.461	0.134	0.242	3.445	0.001	0.199~0.723
VEpeak/MVV	-1.163	1.571	-0.044	-0.740	0.461	-4.242~1.916
VD/VTpeak	-4.070	4.475	-0.055	-0.909	0.366	-12.841~4.701
AT/VO₂peak%pred	19.340	2.120	0.661	9.122	< 0.001	15.184~23.495

Characteristics of cardiorespiratory fitness in patients with post-stroke hemiplegia based on cardiopulmonary exercise testing

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