摘要
心肺移植(HLT)的受者由于手术前和术后的一些因素表现出运动能力下降。本研究的目的是评估11名患者(5名女性和6名男性)的运动能力、骨骼和呼吸肌肉表现的时间进程;年龄(平均+/- SD) 38 +/- 13岁)。所有患者均于术后入住我院接受康复治疗,随访18个月。入院时、出院时以及每6个月对患者进行一次评估:肺功能值;增加跑步机锻炼,6分钟步行距离;最大吸气和呼气压力(分别为MIP和MEP);以及腿部屈肌和伸肌等速收缩的峰值扭矩(分别为IFX和IEX)。入院时,患者有:肺活量(VC)评估肺容量减少(为预测的60 +/- 15%);通过峰值耗氧量(V'O2,峰值)评估运动能力降低(40 +/- 12% pred); reduced skeletal and respiratory muscle performance as assessed by IEX, IFX (48 +/- 16 and 28 +/- 12 Newton-metres (N x m), respectively) and by MIP and MEP (54 +/- 21 and 58 +/- 19 cmH2O, respectively). Ten patients completed the rehabilitation programme. At discharge, no significant change in dynamic and static lung volumes was observed. However, nonsignificant increases in MIP, MEP, IEX, IFX, 6-MWD and V'O2,peak were recorded. After 6 and 12 months, indices of skeletal and respiratory muscle function and V'O2, peak improved further, but still remained lower than normal values. We conclude that in patients with heart-lung transplantation, skeletal and respiratory muscle function and exercise performance are reduced after surgery, that they may improve with time but are still less than normal after 18 months.