摘要
目的:应用心肺运动试验(CPET)评价动脉性肺动脉高压(PAH)患者靶向药物治疗的疗效。方法:连续筛查2014年6月至2015年3月入住我院肺血管病中心的特发性/可遗传性PAH、先天性心脏病性PAH、结缔组织病相关性PAH患者34例。采集患者基线时一般临床资料、常规生化指标、血浆N末端B型利钠肽原(NT-proBNP)、6分钟步行距离、超声心动图、CPET和右心导管数据。所有患者均接受靶向药物治疗3~6个月后再次应用CPET及其他传统指标进行评估。结果:34例PAH患者均应用靶向药物治疗,平均随访(4.8±2.4)个月,经靶向药物治疗后,峰值氧耗量(VO_(2peak))、VO_(2peak)与体重的比值(VO_(2peak)/kg)、峰值氧脉搏(VO_2与心率比值的峰值)、峰值功率、峰值呼气末二氧化碳(PetCO2)、6分钟步行距离等指标均升高(P均<0.05),静息二氧化碳通气当量(VE/VCO2)、VE/VCO2斜率、VE/VCO_2最低值、氧通气当量(VE/VO_2)最低值、NT-proBNP均降低(P均<0.05)。NT-proBNP与VO_(2peak)/kg、VE/VCO_2斜率、VE/VCO2最低值、VE/VO_2最低值等均相关(r=-0.395、0.383、0.484、0.428,P均<0.05);6分钟步行距离与VO_(2peak)、VO_(2peak)/kg、VE/VCO2斜率相关(r=0.603、0.564、-0.607,P均<0.05)。结论:CPET可以定量评价PAH患者的靶向药物疗效,与传统指标相关性较好。
Objectives:To assess the effects of target therapy in patients with pulmonary artery hypertension(PAH)by cardiopulmonary exercise testing(CPET).Methods:In the Center for Pulmonary Vascular Disease Diagnosis and Treatment of our hospital,34 patients with idiopathic/heritable pulmonary artery hypertension(I/HPAH),congenital heart disease associated pulmonary artery hypertension(CHD-PAH),connective tissue disease associated pulmonary artery hypertension(CTD-PAH)diagnosed by right heart catheterization from June 2014 to March 2015 were enrolled into this study.CPET was performed in all patients.Clinical features,routine tests results,N-terminal B-type natriuretic peptide(NT-proBNP),6-minute walking distance(6MWD)results were collected.Data were compared between baseline and after 3-6 months targeted therapy.Results:Thirty-four patients with PAH were enrolled and all treated with target medications for average(4.8±2.4)months.After target therapy,peak VO2,peak VO2/kg,peak VO2/heart rate(HR),peak workload,peak PetCO2,6MWD were all improved significantly(all P<0.05),and rest VE/VCO2,VE/VCO2 slope,lowest VE/VCO2,lowest VE/VO2,NT-proBNP values were all significantly decreased(all P<0.05)compared to baseline values.NT-proBNP was significantly correlated to peak VO2/kg,VE/VCO2 slope,lowest VE/VCO2,lowest VE/VO2(r=-0.395,0.383,0.484,0.428,all P<0.05).6MWD was significantly correlated to peak VO2,peak VO2/kg,VE/VCO2 slope(r=0.603,0.564,-0.607,all P<0.05).Conclusions:CPET can objectively and quantitatively evaluate the effects of target therapy in patients with pulmonary artery hypertension,and CPET parameters correlate with the traditional index used for the assessment of pulmonary artery hypertension.
作者
赵青
马秀平
罗勤
赵智慧
熊长明
柳志红
ZHAO Qing;MA Xiuping;LUO Qin;ZHAO Zhihui;XIONG Changming;LIU Zhihong(Center for Pulmonary Vascular Disease Diagnosis and Treatment,State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)
出处
《中国循环杂志》
CSCD
北大核心
2020年第8期750-754,共5页
Chinese Circulation Journal
基金
中央级公益性科研基金(2015-F06)。
关键词
运动试验
高血压
肺性
靶向药物
心脏功能
呼吸功能
exercise test
hypertension,pulmonary
target medicine
heart function
respiratory function
