Abstract: Background　Heart failure with preserved ejection fraction（HFpEF） is the most prevalent form of heart failure in outpatients.Yet，the pathophysiology of this syndrome is unclear and pharmacological treatment does not improve prognosis.Because breathlessness during activities of daily living is the most frequent complaint of patients with HFpEF，we hypothesize that lung function may be often abnormal in these patients due to either a direct effect of HFpEF and/or shared risk factors.Objective　To explore the frequency，type and severity of lung function abnormalities in HFpEF.Methods　138 cases of newly diagnosed symptomatic HFpEF were selected from Cardiovascular Clinic，Guangdong Tongjiang Hospital between September 2016 and December 2017.Forced spirometry，static lung volumes，diffusing capacity of the lungs for carbon monoxide（DLCO） and arterial blood gases were measured.Results　94.2%（130/138） of the patients showed abnormalities in at least one of the lung function measurements，and 80.8%（105/130） of them were undiagnosed and untreated.Forced spirometry was abnormal in 58.7%（81/138）〔percents of mild，moderate and severe were 23.2%（32/138），26.8%（37/138），8.7%（12/138），respectively〕，DLCO was found in 83.3%（115/138）〔percents of mild，moderate and severe were 47.8%（66/138），29.0%（40/138），6.5%（9/138），respectively〕 and arterial hypoxaemia was present in 60.9%（84/138）〔percents of mild，moderate and severe were 34.8%（48/138），21.0%（29/138），5.1%（7/138），respectively〕.Abnormal spirometry and DLCO were more prevalent in NYHA classⅢ patients than those of NYHA class Ⅰ/Ⅱ patients（P<0.05）.Conclusion　Lung function abnormalities are very frequent in HFpEF patients.Abnormalities in forced spirometry and DLCO，and arterial hypoxaemia are also quite common.Attention should be paid to these abnormalities.A greater awareness of them among clinicians may contribute to improve the management and health status of the patients.

Key words: Heart failure, Heart failure with preserved ejection fraction, Dyspnea, Pulmonary function, Cardiac function

摘要： 背景　射血分数保留的心力衰竭（HFpEF）是门诊最常见的心力衰竭（心衰）形式，但该综合征的病理生理机制仍不清楚，药物治疗不能改善预后。因为气短是HFpEF患者日常生活中的常见主诉，笔者假设由于HFpEF直接效应和/或共存的其他危险因素，这些患者肺功能常常异常。目的　探讨HFpEF患者肺功能异常发生率、类型及严重程度。方法　选取2016年9月—2017年12月在广东同江医院心内科门诊初诊为HFpEF的患者138例，进行用力肺量计检查、静态肺容量和肺弥散量测定，以及动脉血气分析。结果　130例（94.2%）患者存在至少1项肺功能异常，80.8%（105/130）的肺功能异常患者未诊断、未治疗。81例（58.7%）用力肺量计检查异常，轻、中、重度分别为23.2%（32/138）、26.8%（37/138）、8.7%（12/138）；115例（83.3%）肺弥散量异常，轻、中、重度分别为47.8%（66/138）、29.0%（40/138）、6.5%（9/138）；84例（60.9%）有动脉低血氧，轻、中、重度分别为34.8%（48/138）、21.0%（29/138）、5.1%（7/138）。纽约心脏病协会（NYHA）分级Ⅲ级患者的肺量计检查异常发生率、肺弥散量异常发生率高于NYHA分级Ⅰ/Ⅱ级患者（P<0.05）。结论　HFpEF患者肺功能异常发生率较高，用力肺量计检查异常、肺弥散量异常及动脉低血氧常见，应加以关注；临床医生对此的更好理解，或许有助于改善患者管理和健康状况。

关键词: 心力衰竭, 射血分数保留的心力衰竭, 呼吸困难, 肺功能, 心功能