先天性心脏病患者运动心肺功能表现

目的探讨先天性心脏病患者运动负荷测验特点。方法15例患者，男4例，女11例。其中房缺9例，室缺6例。并与年龄相近健康男性4例、女性11例作对照。进行踏车递增负荷运动测验。结果先天性心脏病组VO2max，VO2max占预计值％（＜正常84％）低于对照组；VO2AT，VO2AT／VO2maxpred低于对照组但在正常范围内；此外VO2／HRmax＜VO2／HRmaxpred。有3例心导管证实为肺动脉高压者，运动后PaO2及SaO2减低；P（A－a）O2加宽；P（a－et）CO2正值；VE／VCO2AT异常增高超过45，但BRmax正常。结论先天性心脏病患者运动负荷表现为最大有氧代谢能力减低。VE／VCO2AT异常增高为肺动脉高压、V／Q比率失调、肺循环障碍提供线索。运动后低血氧考虑有右至左分流。

Cardiopulmonary exercise testing in congenital heart disease

Objective To investigate characteristic of cardiopulmonary exercise testing performing incongenital heart disease (CHD). Method Cycleergometer exercise testing was detendned in 15 cases (9 ASD and 6 VSD) 4 male and 11 female compared with the sndlar ace of 4 male and 11 femalehealthy persons as controls. Results In CHDgroup, VO2max and VO2max/VO2max pred (<84% nounal range were lOwer than those of controlgroup. VO2AT and VO2ATNOZmax pred were lower than those of contIDI group but reedned withinnounal cage. VOZ/HRmax < VOZ/HRmax pred inCHD. In three CHD caacs with pullnoneq hypertension condrmed by catheterization PaO2 and SaO2were decreased and P(A - a) OZ was extended at theend of exercise. The value of p(a - et) CO2 wasPOsitive. VE/VCOZAT was increased abnorThallyover the Value of 45 while breath reserve was norInal. COnclusha Maimal aerobic mechlic caPacity reduction was the characteristic of CHD during loading test. That VE/VCOZAT was increasedabnoITnally provided a cue for diagnosis of pullnomphypertension, V/Q mismatch and disonler of pulmoneq circulation. Rigth - left shunt during exercise teshng contributed to hypoxenda.[