川崎氏症青少年之心肺功能及運動能力探討

A Study on Cardiopulmonary Function and Exercise Capacity of Adolescents Suffered from Kawasaki Disease in Childhood

賴家欣(Chia-Hsin Lai) ； 林克隆(Ko-Long Lin) ； 方進隆(Chin-Lung Fang)

《慈惠學報》 11期 (2015/12) Pp. 62-72

https://doi.org/10.6202/THJ-2015-11-06

摘要

川崎氏症（Kawasaki disease, KD）最早由日本川崎富作醫師於1967年針對患者症狀進行臨床觀察研究而提出，目前仍無特定的診斷測試或疾病特有的臨床特徵，因此診斷上以臨床症狀為準則。心血管的影響是川崎氏症急性期的重要議題，目前相關探討患者運動表現的研究較少，本研究目的是為了瞭解兒童時期罹患川崎氏症的青少年其心肺功能及運動能力與一般青少年之間的差異。本研究針對40名心室中膈缺損青少年及40名一般青少年進行心肺功能及運動能力測試。測試結果顯示在心肺功能部分，兒童時期罹患川崎氏症青少年的用力肺活量與第一秒用力吐氣容積和對照組比較皆無顯著差異，且第一秒用力吐氣容積與用力肺活量的比值及最大自主通氣量方面和對照組也無明顯差異。此外，研究組在運動時的最大心跳數與對照組相比較小，但兩組在最大攝氧量及最大收縮壓部分並無顯著差異。本研究的數據顯示，兒童時期罹患川崎氏症青少年的心肺功能與一般青少年比較並無較差的狀況，因此不會造成在運動上的限制。另外在運動時最大心跳表現部分，研究組表現比一般青少年差，其原因可能是因全身性血管炎造成的內皮受損導致成長後心血管病變。對川崎氏症患者而言，長期的心血管觀察是重要的議題，但運動可改善冠狀動脈患者的運動耐力及週邊血管的內皮功能。因此我們建議川崎氏症的患者應該注意避免造成動脈硬化的危險因子，努力維持健康、控制飲食、維持運動以促進心肺功能及生活品質。

關鍵字

急性血管炎 ； 身體活動 ； 心肺適能

並列摘要

Kawasaki Disease (KD) is an acute systemic vasculitis which was first found in 1967 in Japan. The diagnosis of typical or incomplete KD is based on clinical criteria. The clinical features, especially cardiac complications are the leading causes of childhood acquired heart disease. There were only a small number of reviews related to exercise performance on KD. Therefore, cardiopulmonary function and exercise capacity in adolescents post-KD were evaluated through this study. Maximal anaerobic capacity as well as factors of restrictive exercise capacity were evaluated in the study. A cardiopulmonary exercise stress assessment was performed upon 40 adolescents post-KD among the experimental group along with 40 healthy adolescents in the control group. Based on the finding, no significant differences were found in maximal systolic blood pressure and maximum heart rate but VO2 max. Pulmonary function tests also showed no significant differences in forced vital capacity (FVC), forced vital capacity second (FEV1), ventilation (MVV), nor FEV1/FVC. In the presented study, adolescents post-KD showed normal cardiopulmonary function and exercise capacity comparing to those from the healthy group; no limitations in exercise were observed additionally. Thus keep average exercise to maintain quality of life was suggested.

並列關鍵字

Acute systemic vasculitis ； Physical activity ； Cardiopulmonary fitness

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