本研究結果顯示原發性肺動脈高壓患者與次發性患者的運動測試及血液動力 學變化的確存在差異。原發性患者運動能力受到心臟功能的影響大於次發性。次發 性患者運動受限因素可能來自於心臟的右至左分流。受限於受試者人數，本篇研究 結果仍需更多研究證實。根據本篇研究結果建議未來針對肺動脈高壓的研究須依 據不同族群分別探討。而過去針對肺高壓患者運動訓練的研究，並無考慮患者是否 有運動時心臟右至分流的因素，因此建議未來的研究須將此因素納入運動處方訂 定的考量，避免運動訓練對患者產生傷害。而本研究結果也可提供國內肺高壓患者 運動測試的初步資料，做為後續研究與追蹤參考。
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圖一、研究流程圖
（ICD-10-CM 診斷碼 I27.0 或 I27.2）
（3）接受穩定治療且病情無變化 三個月以上
（4）具行走能力，並可執行腳踏 車運動測試
圖二、36 題簡短生活品質量表
0 20 40 60 80 100 120
身體生理功能 生理角色受限 身體疼痛 一般健康狀況 活力狀況 社會功能 情緒角色受限 心理健康 生理總分 心裡總分
分數
36題簡短生活品質量表
原發性肺動脈高壓
次發性肺動脈高壓
表一、肺高壓的血流動力學定義（Hemodynamic definitions of pulmonary hypertension）
定義（definition） 特徵（characteristics） 臨床分類（clinical groups）
肺高壓（pulmonary hypertension, PH） 平均肺動脈壓≧25 mmHg 全部 微血管前肺高壓
（pre-capillary PH）
平均肺動脈壓≧25 mmHg
（post-capillary PH）
單純微血管後肺高壓
（isolated post-capillary PH）
合併微血管前後微肺高壓
（combined post-capillary and pre-capillary PH）
平均肺動脈壓≧25 mmHg
表二、肺動脈高壓的分類
此表翻譯自 2015 年歐洲心臟學會（ESC）和歐洲呼吸學會（ERS）發表肺高壓診 斷及治療指引準則[2]
1. 肺動脈高壓 Pulmonary arterial hypertension(PAH)
1.1 原發性肺動脈高壓 Idiopathic pulmonary arterial hypertension(IPAH) 1.2 遺傳性肺動脈高壓 Heritable pulmonary arterial hypertension (HPAH)
1.2.1 BMPR2 基因突變 1.2.2 其他基因突變 1.3 藥物及毒品所導致
1.4 次發性肺動脈高壓 Association pulmonary arterial hypertension(APAH) 1.4.1 結締組織疾病
1.4.2 愛滋病毒 HIV 感染 1.4.3 肝門靜脈高壓 1.4.4 先天性心臟疾病
1.4.5 血吸蟲病 Schistosomiasis
1’ 靜脈阻塞性疾病與/或肺微血管瘤 Pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis
1’’新生兒持續肺動脈高壓 Persistent pulmonary hypertension of the newborn 2. 由左心疾病引起的肺高壓
4. 慢性血栓栓塞性肺高壓以及其他肺動脈阻塞 Chronic thromboembolic pulmonary hypertension and other pulmonary artery obstructions
5. 病因不明或多重病因的肺高壓
5.1 血液方面的疾病：慢性溶血性貧血、骨髓增生性腫瘤、脾臟切除
5.1 血液方面的疾病：慢性溶血性貧血、骨髓增生性腫瘤、脾臟切除