摘要目的 研究不同类型肺动脉高压患者的运动耐量的变化特点.方法 选择经右心导管检查确诊的肺动脉高压患者118例,其中特发性肺动脉高压(IPAH) 43例、慢性血栓栓塞性肺动脉高压(CTEPH)44例、COPD相关肺动脉高压(COPD-PH) 31例,以及健康志愿者33例进行常规肺功能检测及斜坡式功率递增症状限制性心肺运动试验,测定相关参数.结果 肺动脉高压组患者的峰值摄氧量(PeakVO2)、峰值摄氧量占预计值百分比(Peak(V)O2％ pred)、峰值功率(PeakLoad)、峰值公斤摄氧量(Peak(V)O2/kg)、峰值通气量(Peak(V)E)较正常对照组明显降低,差异有统计学意义(P值均＜0.01).COPD-PH组Peak(V)O2、Peak(V)O2％ pred、PeakLoad、Peak(V)O2/kg、Peak(V)E较CTEPH组显著降低,差异有统计学意义(P值均＜0.05).COPD-PH组PeakLoad、Peak (V)E较IPAH组显著降低(P值均＜0.05),而Peak(V)O2、Peak(V)O2％ pred和Peak(V)O2/kg的差异无统计学意义.IPAH组与CTEPH组Peak (V)O2、Peak(V)O2％pred、PeakLoad、Peak(V)O2/kg、Peak (V)E间的差异无统计学意义.结论 不同类型肺动脉高压患者的血流动力学的异常与运动耐量的降低并不一致,心肺运动试验能更全面的评估患者的病情严重程度及预后.

abstractsObjective To study the changing characteristics of the exercise capacity in patients with different types of pulmonary hypertension.Methods Pulmonary function test and cardiopulmonary exercise test were tested in 118 pulmonary hypertension patients diagnosed by right heart catheterization and in 33 healthy volunteers.There were 3 types of pulmonary hypertension including 43 idiopathic pulmonary arterial hypertension (IPAH),44 chronic thromboembolic pulmonary hypertension (CTEPH),and 31 COPD related to pulmonary hypertension (COPD-PH).Results Compared with normal control group,the Peak (V) O2、Peak (V) O2 ％ pred、PeakLoad、Peak (V) O2/kg、Peak (V) E in patients with pulmonary hypertension were significantly decreased,the difference was statistically significant (P ＜ 0.01).The Peak (V) O2、Peak (V) O2 ％ pred、PeakLoad、Peak (V) O2/kg、Peak (V) E in group COPD-PH were significantly decreased than that in group CTEPH,the difference was statistically significant (P ＜0.05).PeakLoad、Peak (V)E in group COPD-PH were significantly decreased than that in group IPAH,(P ＜ 0.05),but Peak (V) O2 、Peak (V) O2 ％ pred and Peak (V) O2/kg in two groups have no significant statistical difference.There was no significant statistical difference in Peak (V) O2、Peak (V) O2 ％ pred、PeakLoad、Peak (V)O2/kg、Peak (V)E between IPAH and CTEPH groups.Conclusions The abnormality of hemodynamics in patients with different types of pulmonary hypertension was not consistent with the decrease of the exercise capacity,and cardiopulmonary exercise test can be more comprehensive to evaluate the severity and prognosis of patients.