冠心病患者心肺耐力与临床危险因素的相关分析  

The correlation of cardiorespiratory fitness and clinical risk factors in patients with coronary artery disease

作　　者：张燕[1] 张鸿儒[1] 赵璐[1] 钟华[2] 李真[1] ZHANG Yan;ZHANG Hong-ru;ZHAO Lu;ZHONG Hua;LI Zhen(Department of Cardiac Rehabilitation,The First Affiliated Hospital of Dalian Medical University,Dalian 116023,China;Department of Medical Records,The First Affiliated Hospital of Dalian Medical University,Dalian 116023,China)

机构地区：[1]大连医科大学附属第一医院心脏康复科,辽宁省大连市116023 [2]大连医科大学附属第一医院病案室,辽宁省大连市116023

出　　处：《中国心血管病研究》2020年第10期901-905,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨冠心病患者心肺耐力(CRF)减低的临床影响因素及其相关性.方法纳入2019年1月至12月于我院经冠状动脉造影或冠状动脉CT确诊为冠心病并接受症状限制性次级量心肺运动试验测评的患者123例,以峰值代谢当量(METs)为界,分为CRF减低组(<5METs)和CRF正常组(≥5METs),比较两组患者年龄、性别、体重指数、吸烟史、合并疾病情况(包括高血压、糖尿病、心力衰竭、心肌梗死)、β受体阻滞剂应用情况、左心室射血分数、左心室舒张末期内径以及冠状动脉病变支数的差异;并对CRF与上述临床因素的相关性进行分析.结果123例患者中男性108例(87.8%),平均年龄(57.6±10.8)岁、平均体重指数(26.3±3.2)kg/m2.以心肺运动试验参数正常值标准为参考,61.0%的患者峰值METs<5 METs,82.1%的患者峰值摄氧量<20 ml·kg-1·min-1,57%的患者无氧阈时的摄氧量(AT-VO2)<11 ml·kg-1·min-1,52.1%的患者无氧阈METs<3,29.2%的患者通气当量(VE/VCO2)>30,提示冠心病患者的心肺耐力普遍下降.单因素相关性分析结果显示,年龄、性别、吸烟史和糖尿病史与运动耐力显著相关,肯德尔相关系数分别为-0.33、-0.20、0.23、-0.18,P均<0.05.回归分析结果提示,年龄越大、吸烟、合并高血压、左心室内径越大、体重指数越大的患者,其CRF降低的风险越高,B值分别为-0.12、1.16、0.30、-0.10、-0.22,P均<0.05.结论冠心病患者的CRF普遍下降,CRF减低的冠心病患者更易合并多种传统心血管危险因素.Obejctive To ivestigate the rlationship betwen crdiorespiratory finess(CRFP)and einical cardiovascular risk fauctors in patients with coronary heart disease(CAD).Methods A total of 123 patients diagnosed as coronary artery disease and undergone cardiopulmonary exercise test(CPET)were enolled.According to the level evaluated by the Metabolic Equivalents at peak exercise(peak-METs)in CPET,patients were divided into the exercise capacity normal group(peak-METs>5,n=48)and the reduced group(peak-METs<5,n=75).The relationship between low CRF and clinical risk factors was evaluated with univariate correlation analysis and logistic regression analysis.Results Among the 123 patients,108(87.8%)were male,the average age were(57.6+10.8)years;the CRF of 61.0%patients reduced by less than s METs.The results of univariate analysis showed that the age.gender,smoking and diabetes mellius correlated with lower CRF,the Kendall Cofficients were-0.33,-0.20,0.23,-0.18 respectively,all P<0.05.Logistic rgression analysis results showed that patients with older age.smoking,with hypertension,larger left ventricular diameter and larger body mass index were at higher risk of reduced CRF,the B value were-0.12,1.16,0.30,-0.10,-0.22 respectively.all P<0.05.Conclusion The CRF of patients with CAD generally reduce and the patients with reduced CRF are more likely to be combined with a variety of clinical cardiovascular risk factors.

关 键 词：冠状动脉疾病 心肺耐力 心肺运动试验:危险因素 

分 类 号：R473[医药卫生—护理学] R541.4[医药卫生—临床医学]