慢性心力衰竭患者FVC、FEV1、FEV1/FVC %及其与EF%的关系

R. Mollika, S. Begum, Md. Harisul Hoque, Khandaker Nadia Afreen, Elora Sharmin, Sheik Foyez Ahmed
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摘要

背景:慢性心力衰竭(CHF)患者可引起多种肺部并发症,肺功能下降。目的:观察慢性心力衰竭患者FVC、FEV1、FEV1/FVC%及其与EF%的关系。方法:本横断面研究于2016年在达卡Shahbag的Bangabandhu Sheikh Mujib医科大学(BSMMU)生理学系进行。为此,从达卡BSMMU心内科随机选择60例诊断稳定的男性,年龄35-65岁CHF患者。根据疾病分期(C期)和纽约心脏协会(NYHA)功能分级,将研究对象分为NYHA - I级30例和NYHA - ii级30例。选取年龄、性别、BMI相匹配的健康受试者30例作为对照组。采用便携式数字肺活量计测定所有受试者的用力肺活量(FVC)、第1秒用力呼气量(FEV1)、用力呼气比(FEV1/FVC%),评估其通气功能。再次,超声心动图测量射血分数(EF%)范围(≥35% ~≤50%),观察左心室功能。统计分析采用windows版本的SPSS进行独立样本检验和Pearson相关系数检验,以16和p≤0.05为显著性水平。结果:CHF患者FVC和FEV1预测值的平均百分比显著低于健康对照组,FEV1/FVC%显著高于健康对照组。与NYHA i级患者相比,NYHA ii级患者的所有研究变量均显著降低。73.33%的CHF患者有限制性气道梗阻,10.00%有小气道梗阻,16.67%有限制性气道梗阻合并小气道梗阻。慢性心力衰竭患者FVC与FEV1呈正相关(p<0.05), FEV1/FVC%与EF%呈负相关(p<0.05)。结论:以限制性肺疾病为主的左室功能障碍可能与通气功能下降有隐性关联。《大学心脏杂志》第16卷第2期,2020年7月;59 - 64
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FVC, FEV1, FEV1/FVC % and their Relationship with EF% in Patients with Chronic Heart Failure
Background: Chronic heart failure (CHF) causes multiple lung complications and lung functions are reduced in CHF patients. Objective: To observe FVC, FEV1, FEV1/FVC% and their relationship with EF% in patients with chronic heart failure. Methods: This cross sectional study was conducted in the Department of Physiology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, during 2016. For this, 60 diagnosed stable male, aged 35-65 years CHF patients were randomly selected from the Cardiology Department of BSMMU, Dhaka. On the basis of staging of the disease (Stage C) and New York Heart Association (NYHA) functional classification, the study subjects were divided into two groups, 30 patients of NYHA Class- I and 30 patients of NYHA class –II. Thirty (30) apparently healthy Age, Sex and BMI matched subjects were taken as control. To assess the ventilatory function, Forced vital capacity (FVC), Forced expiratory volume in 1st  second (FEV1), Forced expiratory ratio (FEV1/FVC%) of all subjects were measured by a portable Digital Spirometer. Again, Ejection fraction (EF%) ranged (≥35% to ≤50%) were measured by Echocardiogram to observe left ventricular function of the heart. For statistical analysis, Independent sample‘t’ test and Pearson’s correlation co-efficient test was performed by using SPSS for windows version-16 & p≤0.05 was accepted as level of significance. Results: The mean percentage of predicted values of FVC and FEV1 were significantly lower but FEV1/FVC% was significantly higher in CHF patients comparison to the healthy control. All the study variables were significantly lower in patients of NYHA class–II as compared to patients of NYHA class–I. 73.33% CHF patients had restrictive, 10.00% small airway obstruction and 16.67% combined restrictive and small airway obstruction feature. In addition, FVC and FEV1 (p<0.05) was positively and FEV1/FVC% (p<0.05) negatively correlated with EF% in chronic heart failure patients. Conclusion: Left ventricular dysfunction may be silently associated with decrease ventilatory function mainly restrictive type of pulmonary disorder. University Heart Journal Vol. 16, No. 2, Jul 2020; 59-64
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