心肺运动试验(cardiopulmonary exercise testing,CPET)实时监测身体运动应激时O2吸入量和CO2呼出量,运用计算机及踏车(平板)技术,从而实现对人体综合、系统地评估.CPET在心血管疾病与呼吸系统疾病等领域中被广泛运用,却罕见于脑卒中领域,但脑卒中患者心肺功能障碍真实存在,并会带来一系列危害,对其心肺功能进行评估有一定的必要性.在相关文献中并未发现脑卒中患者进行CPET时出现严重不良事件,对于有平衡问题的脑卒中患者,在测试时建议使用带有靠背的自行车或减重跑步机,对于中重度功能障碍的患者,建议使用半卧位、平卧位自行车或整个身体靠坐的踏阶设备(total-body recumbent stepper,TBRS).测试时判定脑卒中患者是否达到最大努力的标准中,呼吸交换率(respiratory exchange ratio,RER)>1.0似乎是一个合理的标准,现存研究结果普遍提示脑卒中患者心肺适能(VO2peak)降低,所以应对其心肺功能积极评估与干预.本文综述在卒中患者中开展CPET的相关研究进展,以期为临床推广卒中患者的CPET提供参考依据.%Cardiopulmonary exercise testing (CPET) can monitor O2 inhalation and CO2 exhalation in real time during physical exercise stress, and can make use of computer and treadmill (plate) technology, so as to achieve a comprehensive and systematic assessment of the human body. CPET is widely used in the fields of cardiovascular and respiratory diseases, but it is rare in the field of stroke. But the cardiopulmonary dysfunction of stroke patients exists, and will bring a series of damages, so the cardiopulmonary function evaluation is necessary. In the related literatures, no serious adverse events were found in stroke patients during CPET. For stroke patients with balance problems, a bicycle with a backrest or a treadmill with weight support is recommended during the test. For patients with moderate and severe dysfunction, it is recommended to use a semi decubitus position, a supine bicycle, or a total-body recumbent stepper (TBRS). Respiratory exchange ratio(RER) >1.0 seems to be a reasonable standard in determining whether stroke patients reach their maximum effort. The results of existing researches generally suggested cardiopulmonary fitness (VO2peak) reduced in stroke patients, therefore, the cardiopulmonary function of stroke patients should be actively evaluated and intervened.This article reviews the related research progress in the development of CPET in stroke patients, in order to provide reference for the clinical promotion of CPET for stroke patients.
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