无氧代谢阈值在心功能评价中的应用

４３例健康人和１７５例心脏病患者作心－肺运动试验，以评价心功能不全的程度。采用自行车运动递增负荷试验，通过监测每分钟换气量（ＶＥ）、氧摄取量（ＶＯ２）和二氧化碳排出量（ＶＣＯ２）来确定无氧代谢阈值（ＡＴ）。同时也测定峰值ＶＯ２（ＰＶＯ２）和％ＡＴ。ＡＴ［ｍｌ／（ｍｉｎ·ｋｇ）］和ＰＶＯ２［ｍｌ／（ｍｉｎ·ｋｇ）］随年龄增大而下降，男性上述值均高于女性。％ＡＴ值（从年龄和性别预测的ＡＴ值经校正后的ＡＴ百分数）在心功能不全组随ＮＹＨＡ级别增高而降低；心功能Ⅰ、Ⅱ、Ⅲ级分别为８５．３％±１０．３％、７４．７％±１４．１％和５８．８％±１２．８％。１２例间隔３ｈ所测ＡＴ值重复性好（ｒ＝０．８５）。结果表明，心－肺运动试验的指标，特别是ＡＴ可以用作评价心功能不全的客观指标及其心功能不全治疗的效果。

The Anaerobic Threshold Measurement for Evaluation of Chronic Cardica Failure

Cardio-pulmonary tests was performed on 43 normal subjects and 175 patients with cardiac disease in order to evaluate the severity of heart failure.AT could be determined easily during the bicycle ergometer test by measuring minute ventilation(VE),oxygen uptake(VO2) and carbon dioxide output(VCO2).Peak VO2 and %AT were also determined. Both ATml/(min·kg)]and peak VO2ml/(min·kg)]declined with age,however the males showed higher values than the females in hoth indices,%AT(determined by the predicted AT values of each age and sex),decreased as class of NYHA progressed(i.e 85.3% ±10.3% in class Ⅰ,74.7%±14.1% in class Ⅱ,and 58.8%±12.8% in class Ⅲ).The reproducibility of AT was excellent in two tested for in a 3-hour interval. These results suggested that indices from the cardio-pulmonary exercise tests,especially from AT, were closely related to the pathophysiology of heart failure so that they might be used as objective parameters and were reliable for evaluation of the severity of heart failure and are sensitive enough to detect the efficacy of therapeutic intervention for heart failure.