儿童心肺运动试验生理指标医学参考值的初步研究

目的 研究儿童心肺运动试验(CPET)生理指标及其变化规律,以期建立儿童心肺运动试验正常参考值范围。方法 采用心肺运动测试系统按照标准CPET方案对450例健康儿童进行心肺运动试验,每1自然岁50例,男女各半。检测指标包括无氧阈(VO₂@AT)、峰值摄氧量(VO₂峰值)、峰值氧脉搏(峰值VO₂/HR)、二氧化碳通气当量最低值(VE/VCO₂最低值)、二氧化碳通气当量斜率(VE/VCO₂ slope)、摄氧效率斜率(OUES)、峰值负荷功率(Pmax)、峰值心率(HRmax)和最大分钟通气量(VEmax)。结果 男童VO₂峰值为:4~6岁:(816.36±152.03)ml/min;7~9岁:(1 132.19±261.6)ml/min;10~12岁:(1 418.99±270.2)ml/min。女童VO2峰值为:4~6岁:(700.36±139.77)ml/min;7~9岁:(1 004.19±198.5)ml/min;10~12岁:(1 264.97±230.2)ml/min。VO₂@AT、VO₂峰值、峰值VO₂/HR、OUES、Pmax和VEmax均随年龄增长而增加(P均<0.001),而VE/VCO₂最低值及VE/VCO₂ slope随年龄增长而降低(P均<0.001)。并建立了各核心指标正常预计值公式,其中峰值VO₂/HR=-2.757+0.148×年龄(y)+0.049×身高(cm)+0.040×体重(kg)+0.892×性别(“男”=1,“女”=0)。结论 本研究是针对国内儿童心肺运动试验医学参考值的较大样本研究,在国内无儿童心肺运动试验医学参考值判断标准的情况下,可以参考本项研究结果。

Preliminary study on the medical reference value of physiological indexes for cardiopulmonary exercise testing in children

Objective To study the physiological indexes of children receiving cardiopulmonary exercise testing(CPET)in order to establish the normal CPET reference value in Chinese children. Methods Four hundred and fifty healthy children underwent the CPET with the standard scheme using the cardiopulmonary testing system.There were fifty children per age,and the gender ratio was 1∶1.The indexes included oxygen uptake at anaerobic threshold (VO₂@AT),peak oxygen uptake (VO₂ peak),peak oxygen pulse (peak VO₂/HR),minimum of respiratory minute volume to CO₂ production (VE/VCO₂ minimum),slope of respiratory minute volume to CO₂ production (VE/VCO₂ slope),slope of oxygen uptake efficiency (OUES),peak tolerance power (Pmax),peak heart rate (HRmax) and maximal minute ventilation(VEmax). Results The VO₂ peak of boys was:4~6 years old:(816.36±152.03)ml/min;7~9 years old:(1 132.19±261.6)ml/min;10~12 years old:(1 418.99±270.2)ml/min respectively.The VO₂ peak of girls was:4~6:(700.36±139.77)ml/min;7~9 years old:(1 004.19±198.5)ml/min;10~12:(1 264.97±230.2)ml/min.VO₂@AT,VO₂ peak,Peak VO₂/HR,OUES,Pmax and VEmax all increased with age (P<0.001).VE/VCO₂ minimum and VE/VCO₂ slope decreased with age(P<0.001).The prediction equations for the above indexes were established by parameters of anthropometry.Peak VO₂/HR=-2.757+0.148×age (y) +0.049 × height (cm) +0.040× weight (kg) +0.892 × gender ("boys" =1,"girls" =0). Conclusions This study is to provide CPET medical reference value based on a large sample of Chinese children.The study can be used under the circumstances that there is no pediatric medical reference of CPET in China.