无氧代谢阈值在慢性心力衰竭心功能Ⅰ~Ⅲ级患者定量分级中的作用

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目的:通过对慢性心力衰竭患者无氧代谢阈值(AT)的检测来探讨其在心功能分级中的作用。方法对2007年8月至2013年6月期间入住同济大学附属同济医院心内科的患者进行选择,经心脏超声确定左室射血分数(LVEF)<0.49的慢性心力衰竭患者129例为慢性心力衰竭组(缺血性心肌病患者74例,扩张型心肌病患者55例;或纽约心脏联合会(NYHA)Ⅰ级5例,Ⅱ级68例,Ⅲ级56例),并实施心肺运动试验(CPET)检测AT,以无氧代谢阈值氧耗量(VO2AT)表示。对照组为129例健康者。结果(1)慢性心力衰竭组VO2AT与对照组差异有统计学意义[(10.5±2.3) vs (15.2±2.7)ml/(kg·min),P<0.01]。(2)NYHA Ⅰ级、NYHA Ⅱ级、NYHA Ⅲ级慢性心力衰竭患者VO2AT依次减小,差异有统计学意义[(13.4±1.7) vs (10.9±2.3) vs (9.6±2.1)ml/(kg·min), P<0.05]。经单因素相关性分析,VO2AT与NYHA呈负相关(r=-0.732,P<0.01)。结论 VO2AT与NYHA心功能分级具有相关性,以VO2AT定量评估我国慢性心力衰竭患者心功能具有可能。
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