| 冉欣,姜效韦,陈伟,李瑾.非小细胞肺癌合并冠心病患者运动耐量、通气效率特点的临床研究[J].中国康复,2025,40(4):223-228 |
| 非小细胞肺癌合并冠心病患者运动耐量、通气效率特点的临床研究 |
| Characteristics of exercise tolerance and ventilatory efficiency in patients with non-small cell lung cancer complicated with coronary heart disease |
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| DOI：10.3870/zgkf.2025.04.006 |
| 中文关键词: 非小细胞肺癌 冠心病 心肺运动试验 通气效率 运动耐量 |
| 英文关键词: non-small cell lung cancer coronary artery disease cardiopulmonary exercise testing ventilatory efficiency exercise tolerance |
| 基金项目:徐州市科技计划项目（KC20136） |
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| 摘要点击次数: 92 |
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| 中文摘要: |
| 目的：基于心肺运动试验 (CPET) 结果，探讨非小细胞肺癌（NSCLC）合并冠心病（CHD）患者运动耐量、通气效率的临床特点。方法：选取NSCLC合并CHD患者60例为NSCLC-CHD组，通过检索电子病例系统，使用倾向性评分法1∶1匹配出单纯NSCLC患者60例为NSCLC-non CHD组。采集2组患者CPET指标进行比较分析。结果：2组患者CPET核心指标比较：NSCLC-CHD组患者峰值摄氧量 (peak VO2)、公斤摄氧量 (peak VO2/kg)、峰值摄氧量占预计值百分比 (peak VO2/pred%)、最大功率 (peak WR)均低于NSCLC-non CHD组 (P<0.05)，二氧化碳通气当量斜率 (VE/VCO2 slope) 及其最低值 (VE/VCO2 nadir) 高于NSCLC-non CHD组 (P<0.05)；2组患者CPET 4个阶段指标比较：NSCLC-CHD组VO2 (峰值)、VCO2 (峰值)、PETCO2（4个阶段）、心率恢复值 (1~4min) 低于NSCLC-non CHD组 (P<0.05)，VE/VCO2 (峰值)、HR (热身、无氧阈值)高于NSCLC-non CHD组 (P<0.05)；2组患者静态肺功能指标比较：NSCLC-CHD组的第1秒用力呼气容积 (FEV1)、第1秒用力呼气容积占用力肺活量百分比 (FEV1/FVC)、每分钟最大通气量 (MVV)、用力肺活量 (FVC)、呼气流量峰值 (PEF) 及其绝对值占预计值百分比 (FEV1%，FVC%，MVV%，PEF%) 均低于NSCLC-non CHD组 (P<0.05)。结论：NSCLC-CHD组患者的运动耐量及通气效率较NSCLC-non CHD组患者差；CPET有望为合并有CHD的NSCLC患者的肺切除术前的风险评估提供依据。 |
| 英文摘要: |
| Objective: To explore the characteristics of cardiopulmonary function during cardiopulmonary exercise testing (CPET) in patients with non-small cell lung cancer (NSCLC) complicated with coronary heart disease (CHD). Methods: From November 2020 to June 2022, a total of 60 patients with NSCLC complicated with CHD who were admitted for the first time to the Department of Thoracic Surgery at Xuzhou Central Hospital were selected as the experimental group. Then, using propensity score matching with a ratio of 1∶1 in the Department of Thoracic Surgery database and electronic medical record database, 60 patients with pure lung cancer (non-NSCLC CHD group) were matched as the control group, with matching criteria including gender, age, body mass index, smoking history, exercise habits, lung cancer pathological type, and clinical stage. The specific indicators of CPET were collected from both groups for comparative analysis, and the experimental results were observed. Results: Comparison of core indicators of CPET between the two groups revealed that in the NSCLC-CHD group, peak WR, peak VO2, peak VO2/pred%, and peak VO2/kg were lower than those in the non-NSCLC CHD group, while VE/VCO2slope and VE/VCO2nadir were higher than those in the non-NSCLC CHD group. The differences between the two groups were statistically significant (P<0.05). There was no statistically significant difference in AT, peak O2 pulse, and RERpeak between the two groups (P<0.05). Comparison of four stage indexes of CPET between the two groups showed that VO2 (peak), VCO2 (peak), PETCO2 (four stages) and heart rate recovery value (1-4 mins) in NSCLC-CHD group were lower than those in non-NSCLC CHD group, while VE/VCO2 (peak value), heart rate (warm up, AT) were higher than those in non-NSCLC CHD group. The difference was statistically significant (P<0.05). The comparison of static lung function indicators between the two groups indicated that in the NSCLC-CHD group, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, maximum voluntary ventilation (MVV), peak expiratory flow (PEF), and their percentage of predicted values (FEV1%, FVC%, MVV%, PEF%) were all lower than those in the non-NSCLC CHD group (P<0.05), and the differences were statistically significant. Conclusion: Exercise tolerance and ventilation efficiency of NSCLC-CHD patients were worse than those without CHD. CPET can provide a basis for pre-pneumonectomy risk assessment in NSCLC patients with CHD. |
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