二氧化碳換氣當量與左心室輸出率之關係研究

藉著非侵入性氣體交換分析的方法偵測通氣量、攝氧量及二氧化碳生成量等數值，可有效的評估病人心肺功能、預後及治療後的反應。有文獻指出二氧化碳換氣當量隨時間變化的圖形，在輕度心臟衰竭的病人呈現L形曲線，中度心臟衰竭的病人呈現U形曲線，重度心臟衰竭的病人呈現直線反應，其方法是以整體運動時間及最大攝氧量作為判定心臟衰竭的依據，故曲線結果值得進一步釐清。本研究是以３６位病患為對象，依其左心室輸出率分為三組：A組１３人，其左心室輸出率大於５０%，B組１３人，其左心室輸出率介於３５%及５０%之間，C組１０人，其左心室輸出率小於３５%。分析各組不同時間內二氧化碳換氣當量之變化情形，結果顯示三組不同之病人，其曲線彼此無差異存在，故無法以二氧化碳換氣當量隨時間變化的圖形來評估心臟衰竭的嚴重程度。

關鍵字

運動心肺功能測試；左心室輸出率；二氧化碳換氣當量

並列摘要

Cardiopulmonary exercise testing is a powerful non-invasive mean for objectively assessing the exercise response of patients with cardiovascular or respiratory disease. The ventilatory equivalent for CO2(V E/V CO2)derived from gas exchange analysis is considered to be an estimate of dead space ventilation and provides an assessment of the efficiency of minute ventilation during exercise. Clark and associates showed that the V E/V CO2 ratio differentiated patients into subgroups in terms of the severity of congestive heart failure by measuring the maximal oxygen consumption and the duration of exercise time. Our study was designed to differentiate patients into subgroups by measuring the ejection fraction of the left ventricle, an index of ventricular function. The V E/V CO2 ratio during exercise was measured in 36 patients and these patients were divided into three groups which included 13 patients with an ejection fraction above 50%, 13 patients with an ejection fraction between 35% and 50% and 10 patients with an ejection fraction below 35%. We plotted the V E/V CO2 ratio versus time and found that there were no differences between the three groups. Our plot differed from the plot of Clark et al. According to our results, the curve for V E/V CO2 versus time was not able to predict the severity of heart function.

並列關鍵字

cardiopulmonary exercise testing,ejection fraction ； left ventricle ； ventilatory equivalent,carbon dioxide

國際替代計量

二氧化碳換氣當量與左心室輸出率之關係研究

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