慢性阻塞性肺疾病患者六分钟步行试验中的心肺不良事件

摘要

目的 探讨稳定期慢性阻塞性肺疾病(COPD)患者6 min步行试验(6MWT)过程中心肺不良事件的发生情况与不同程度肺功能和心脏合并症的关系.方法 将85例完成试验的COPD患者依合并症情况分为单纯COPD组(Ⅰ组)16例、COPD合并左心舒张功能减低组(Ⅱ组)31例、COPD合并左心舒张功能减低及慢性肺源性心脏病组(Ⅲ组)38例,分别对3组患者6MWT前、试验结束时与试验结束后10 min的心率(HR)、血氧饱和度(SpO2)进行比较.结果 85 例中共27 例(31.76%)休息1～3 次后完成试验,19 例(22.35%)HR 异常;14 例(16.47%)SpO2<0.90;15 例(17.65%)先后出现HR>120 次/min、SpO2<0.90.Ⅰ组、Ⅱ组、Ⅲ组患者试验结束时HR较试验前、试验后10 min HR较试验结束时,Ⅲ组患者试验后10 min较试验前差异均有统计学意义(均P < 0.05).Ⅱ组和Ⅲ组患者试验结束时SpO2较试验前、试验后10 min SpO2较试验结束时与试验前差异有统计学意义(P < 0.05).结论 重度以上COPD合并左心舒张功能减低及慢性肺源性心脏病者在6MWT过程中易发生心肺不良事件,且试验结束后HR和SpO2不易恢复到试验前状态.%Objective To investigate the relationship of cardiopulmonary adverse events during 6-minute walk test (6MWT) with different lung function and cardiac complications in patients with chronic obstructive pulmonary disease (COPD).Methods Eighty-five COPD patients who finished the test were divided into three groups according to their complications, consisted of COPD group (Ⅰ, n=16), COPD + left ventricular diastolic dysfunction group (Ⅱ,n=31) and COPD + left ventricular diastolic dysfunction + chronic pulmonary heart disease group(Ⅲ ,n=38). The values of heart rate (HR) and pulse oxygen saturation (SpO2) were compared between three groups before and after the test of 6MWT, 10 mins after the test of 6MWT. Results There were 27cases (31.76% ) finished the test of 6MWT. Results showed there were abnormal heart rhythms in 19 cases (22.35%) , SpO2<0.90 in 14 cases (16.47%) and HR >120 bpm or SpO2<0.90 in 15 cases (17.65%). There were significant differences in HR before and after the tests between three groups (P < 0.05). There were significant differences in SpO2 before and after the tests between group Ⅱ and group Ⅲ(P< 0.05). Conclusion Severe COPD patients with left ventricular diastolic dysfunction and chronic pulmonary heart disease are more likely to occur cardiopulmonary adverse events during the test of 6MWT, and the HR and SpO2 are not easy to return to the level before the test.