老年冠心病患者介入治疗术后随访期症状限制性运动试验评估研究  

The study of symptom limited exercise test in elderly patients after percutaneous coronary intervention

作　　者：孙福成[1] 陈刚[2] 季福绥[1] 何青[1] 许锋[1] 林颖[1] 沈月莉[1] 杨玉珍[1] 顾欣[2] 王茂斌[2] 

机构地区：[1]卫生部北京医院心内科,100730 [2]卫生部北京医院康复科,100730

出　　处：《中华老年医学杂志》2004年第11期769-772,共4页Chinese Journal of Geriatrics

基　　金：中央保健委员会保健科研基金 (编号 0 0 5 )

摘　　要：目的　通过运动试验方法评估老年人介入治疗后随访结果。　方法　对成功介入治疗后的患者在随访期间进行症状限制性自行车运动试验 ,分为老年组与非老年组 ,对运动量及心电图等参数进行比较。　结果　老年组和非老年组分别有 2 3例及 30例 ,患者于术后 (1 4 8± 1 2 0 )个月和(1 2 4± 1 2 1 )个月进行了运动试验。老年组和非老年组运动中的心率增加分别为 (92 1± 1 2 6 )次 /min和 (96 5± 1 3 8)次 /min(P >0 0 5 ) ,收缩压增加分别为 (5 9± 1 7)mmHg和 (6 9± 1 6 )mmHg(P >0 0 5 )。老年组和非老年组的最大运动量分别为 (5 8± 1 5 )代谢当量和 (7 2± 1 4)代谢当量 (P <0 0 1 ) ,运动时间为 (6 5± 2 2 )min和 (8 9± 2 6 )min(P <0 0 1 ) ,老年组较非老年组在运动中更易出现症状 (2 1 7%对 3 3% ,P <0 0 5 )及心电图改变 (43 5 %对 1 6 7% ,P <0 0 5 )。　结论　老年人介入治疗后运动量及运动时间均小于非老年人 ,运动中易出现症状及心电图心肌缺血表现。Objective To evaluate the exercise capacity in elderly patients post percutaneous coronary intervention (PTCI) with symptom limited bicycle exercise test at follow up. Methods The bicycle exercise test were performed in patients with successful percutaneous coronary intervention at follow up.The patients were divided to elderly group aged ≥60 years and non elderly group aged<60 years. The results of exercise capacity and ECG changes were compared between the two groups. Results Twenty three patients in the elderly group and 30 in the non elderly group had bicycle exercise test at (14.8±12 0)months and (12 4±12 1)months after PTCI. The increments of heart rate and systolic blood pressure during exercise were not significantly different between the groups〔(92 1±12 6)beats/min vs. (97±14)beats/min, P >0 05 and (59± 17) mm Hg vs (69±16 mm Hg), P >0 05〕. The maximal exercise capacity and time were significantly lower and shorter in the elderly group than those in the non elderly group〔(5 8±1 5)METS vs. (7 2±1 4)METS, P <0 01 and (6 5±2 2)minutes vs. (8 9±2 6)minutes, P <0 01,respectively〕. The symptoms and ECG changes during exercise were more common in the elderly group than those in the non elderly group(21 7% vs 3 3%, P <0 05 and 43 5% vs. 16 7%, P <0 05). Conclusions The exercise capacity during exercise test after percutaneous coronary intervention in the elderly is significantly lower than that in the non elderly with the shorter time exercise. And more elderly patients have symptomatic and ECG changes during exercise test. The evaluation using symptom limited exercise test in elderly patients after percutaneous coronary intervention is safe and valuable.

关 键 词：老年人 冠心病 介入治疗 限制性运动试验 放射学 运动试验 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病] R815[医药卫生—内科学]