川崎氏症兒童之心肺功能及運動能力

Cardiopulmonary Function and Exercise Capacity in Children with Kawasaki Disease

王昱菱(Yu-Ling Wang) ； 楊艾倫(Ai-Lun Yang) ； 王志龍(Jue-Long Wang) ； 楊鈞涵(Chun-Han Yang) ； 何正宇(Zheng-Yu Hoe) ； 黃建銘(Chien-Ming Huang) ； 林克隆(Ko-Long Lin)

《台灣復健醫學雜誌》 36卷4期 (2008/12) Pp. 209-215

https://doi.org/10.6315/2008.36(4)02

摘要

川崎氏症所引起的冠狀動脈併發症居小兒後天性心臟病排行榜的首位，對於此疾病的病因、診斷、治療及併發症相關的研究報導已有許多，但在此類兒童病患的最大有氧能力及運動能力限制因素的研究目前仍缺乏。
本研究收集16名川崎氏症病童做實驗組，16名正常兒童爲對照組來做心肺功能及運動能力的比較。結果顯示川崎氏症患者的最大攝氧量較對照組爲低(8.06±2.13/10.24±2.39MET，p=0.01)，運動時所達到之最大心跳與對照組間並無顯著差異(178.10±11.3/176.56±10.00 bpm，p=0.34)，運動時所達到之最高收縮壓較對照組爲低(144.19±27.39/163.40±21.64 mmHg，p=0.02)；在肺功能方面，川崎氏症患者的用力肺活量(forced vital capacity, FVC)較對照組爲高(2.60±0.85/2.00±0.82L，p=0.03)，但其他方面包括第一秒用力吐氣容積(forced expiratory volume in one second, FEV1)、最大自主通氣量(maximum voluntary ventilation, MVV)、第一秒用力吐氣容積與用力肺活量比值(FEV1/FVC)則和對照組間並無顯著差異。
由上述結果可以得知，患有川崎氏症的兒童其心肺有氧能力確實較同年齡同性別的兒童差，而影響最大運動能力(Maximal Exercise Capacity)因素可能爲過度限制其運動或其心臟功能、肺臟功能差所導致，若能經由運動測試後給予適當之復健運動處方與建議，將有助於川崎氏症病童心肺功能與生活品質的提升。

關鍵字

運動能力 ； 川崎氏症 ； 心肺功能測試

並列摘要

Kawasaki disease complicated by coronary artery disease is the leading cause of acquired heart disease in children. Maximal anaerobic capacity and factors of restrictive exercise capacity need to be evaluated.
To study the influence of Kawasaki disease on cardiopulmonary function and exercise capacity, sixteen children were recruited for the experimental group and given a cardiopulmonary exercise stress test. Sixteen healthy children were recruited as the control group. Based on the findings, the VO2(subscript max) (8.06±2.13/10.24±2.39MET, p=0.01) and the maximal systolic blood pressure (144.19±27.39/163.40±21.64mmHg, p=0.02) demonstrated statistically significant differences between children with Kawasaki disease and healthy children, but no significant difference in maximum heart rate (178.10±11.3/176.56±10.00 bpm, p=0.34). Pulmonary function tests showed significant differences in forced vital capacity (FVC) (2.60±0.85/2.00±0.82L, p=0.03), but no statistical differences in forced expiratory volume in one second (FEV1), maximum voluntary ventilation (MVV), and FEV1/FVC.
Our results show that the cardiopulmonary function of children with Kawasaki disease was worse than that of healthy children. Lower maximal exercise capacity might be caused by over-restricted exercise or cardio-pulmonary dysfunction. We believe that an appropriate exercise prescription and cardiac rehabilitation can improve cardiopulmonary function and quality of life in children with Kawasaki disease.

並列關鍵字

exercise capacity ； Kawasaki disease ； cardiopulmonary function test