Xiao Xuwen,Qu Jiangbo,Shi Hui,et al.Evaluation of exercise capacity in children after cardiac sugical operation[J].Journal of Clinical Pediatric Surgery,2021,20(06):538-544.[doi:10.12260/lcxewkzz.2021.06.007]
儿童先天性心脏病手术后运动耐量的评价
- Title:
- Evaluation of exercise capacity in children after cardiac sugical operation
- 分类号:
- R541.1;R332.1
- 摘要:
- 目的 探讨不同严重程度先天性心脏病（congenital heart disease，CHD）手术后儿童与健康同龄儿童运动耐量的差异。方法 对广州市妇女儿童医疗中心2018年12月至2020年12月心血管专科门诊随访的502名6~18岁CHD手术后患者与186名健康儿童进行心肺运动试验（cardiopulmonary exercise test，CPET）。将CHD患者分为SCHD组（简单先天性心脏病组）、CCHD组（复杂先天性心脏病组）和TCPC组（全腔静脉肺动脉连接组），分别与健康对照组比较CPET各项指标的差异。结果 SCHD组、CCHD组和TCPC组最大摄氧量占预测值百分比（VO2 max%）分别为（0.90±0.12）%、（0.82±0.15）%和（0.72±0.13）%，均较健康对照组的（0.98±0.15）%低（P<0.05）。SCHD组、CCHD组和TCPC组VO2 max%大于80%的比例分别为88%、65%和27.9%，差异有统计学意义（P<0.001）；CHD患者VO2 max每年下降2.26 mL·min-1·kg-1，相应VO2 max%下降5.7%。TCPC组相较其他组儿童每年VO2 max和VO2 max%平均下降最大（VO2 max：3.05 mL·min-1·kg-1，VO2 max%：8.3%）。结论 大部分双心室矫正的简单和复杂先天性心脏病儿童的运动耐量接近正常儿童（VO2 max%>80%），但TCPC组儿童运动耐量明显低于健康儿童。
- Abstract:
- Objective To evaluate and compare the physical fitness of children with different severity of cardiac defect with their healthy peers.Methods For this cross-sectional observational study,502 children after operation for congenital heart disease (CHD) and 186 healthy children as controls were recruited.The age was 6-18 years.Complete cardiopulmonary exercise test (CPET) was performed.Based upon diagnostic characteristics and surgical methods,CHD children were further assigned into three subgroups of simple CHD (SCHD),complex CHD (CCHD) and total cavopulmonary connection (TCPC).Physical fitness was compared between groups using generalized linear model and multiple linear regression analysis.Results As compared with age/gender-adjusted healthy controls,SCHD,CCHD and TCPC subgroups had accordingly graded down values of %predicted VO2max (0.98±0.15 vs.0.90±0.12 vs.0.82±0.15 vs.0.72±0.13,P<0.05).The proportion of %predicted VO2max above 80% in the subgroups of SCHD,CCHD and TCPC were (88% vs.65% vs.27.9%,P<0.001).VO2max decreased by 2.26 ml/kg/min per year in CHD children and the corresponding % predicted reference diminished by 5.7%.Children with TCPC had the highest mean reduction of VO2max and %predicted VO2max per year of age (3.05 mL/kg/min,corresponding 8.3%). Conclusion Although the mean overall physical fitness of children with simple/complex defect after biventricular correction are significantly different from healthy population,they are close to normal (>80%predicted VO2max).However,TCPC group has a much lower exercise capacity.
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备注/Memo
收稿日期:2021-03-28;。
基金项目:广州市高水平临床重点专科项目
通讯作者:崔彦芹,Email:2968037903@qq.com