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目的探讨原发性高血压(EH)患者摄氧效率斜率(OUES)与体质量指数(BMI)的相关性。方法入选健康成人32例和EH患者56例,按BMI将EH患者分为3个亚组:体质量正常组(BMI18.5～23.9kg/m2,18例),超重组(BMI24.0～27.9kg/m2,18例)和肥胖组(BMI≥28.0kg/m2,20例)。采用症状限制性标准Bruce分级平板运动方案,同时测定气体代谢指标摄氧量、二氧化碳排出量、峰值摄氧量(VO2peak)、每分通气量(VE)、呼吸气体交换率(RER)。根据心肺运动试验的实测数据,采用对数曲线拟合的方法,分析递增负荷运动试验中摄氧量与VE的关系,建立回归方程,摄氧量=a×lgVE+b,计算a为OUES值。运动过程中摄氧量为75%VO2peak,90%VO2peak和100%VO2peak时的OUES值分别表示为OUES75、OUES90、OUES100。采用Hollenberg等提出的预测公式计算OUES100的预计值(preOUES100)。结果递增负荷运动试验中,EH超重组和EH肥胖组的OUES100、OUES90、OUES75均高于对照组及EH体质量正常组,EH肥胖组与EH超重组之间比较无统计学差异。EH肥胖组preOUES100高于其他各组。BMI与OUES100呈正相关(r=0.414,P<0.01),与preOUES100、OUES90和OUES75之间也呈正相关。结论EH患者BMI与OUES呈正相关,随着BMI增加,OUES得到一定改善,但伴有肥胖的EH患者OUES未比超重者有进一步改善。
Objective To investigate the correlation between the oxygen consumption efficiency slope (OUES) and body mass index (BMI) in patients with essential hypertension (EH). Methods 32 healthy adults and 56 EH patients were enrolled in this study. According to BMI, EH patients were divided into 3 subgroups: normal weight group (BMI 18.5-23.9kg / m2, 18 cases), overweight group (BMI 24.0-27.9 kg / m2, 18 cases) and obesity group (BMI≥28.0kg / m2, 20 cases). At the same time, the gas metabolic index Oxygen uptake, carbon dioxide emission, peak oxygen uptake (VO2peak), VE, and respiratory gas exchange rate (RER) were determined by using the Bruce staged symptom-limited treadmill exercise plan. According to the measured data of cardiopulmonary exercise test, logarithmic curve fitting method was used to analyze the relationship between oxygen uptake and VE in incremental load exercise test. The regression equation was established, the oxygen uptake was a × lgVE + b, and a was calculated as OUES . The OUES values at 75% VO2peak, 90% VO2peak and 100% VO2peak during exercise are shown as OUES75, OUES90, OUES100, respectively. The predicted value of OUES100 (preOUES100) is calculated using the prediction formula proposed by Hollenberg et al. Results In the progressive exercise test, the OUES100, OUES90 and OUES75 in the EH overweight and EH obese groups were all higher than those in the control group and the EH normal weight group. There was no significant difference between the EH obesity group and the EH overweight group. EH obesity group preOUES100 higher than the other groups. There was a positive correlation between BMI and OUES100 (r = 0.414, P <0.01), and positively correlated with preOUES100, OUES90 and OUES75. Conclusions There is a positive correlation between BMI and OUES in EH patients. The OUES is improved with the increase of BMI, but OUES in obese EHS patients is not improved more than that in OES patients.