冠状动脉临界病变患者心肺运动试验的特点及临床意义  

Features of cardiopulmonary exercise test in patients with intermediate coronary stenosis

作　　者：王国栋[1,2] 唐丽[1,2] 刘杰[1,2] 林伟[1,2] 张焱[1,2] 左雪冰 WANG Guodong;TANG Li;LIU Jie;LIN Wei;ZHANG Yan;ZUO Xuebing(Capital Medical University School of Rehabilitation Medicine,Beijing 100068,China;Department of Cardiology,Beijing Bo'ai Hospital,China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]首都医科大学康复医学院,北京市100068 [2]中国康复研究中心北京博爱医院心血管内科,北京市100068

出　　处：《中国康复理论与实践》2022年第7期833-840,共8页Chinese Journal of Rehabilitation Theory and Practice

基　　金：中国康复研究中心科研项目(No.2019ZX-24)。

摘　　要：目的回顾性分析冠状动脉临界病变患者心肺运动试验的临床特点和功能能力的变化。方法回顾分析北京博爱医院2015年1月至2020年1月行冠状动脉造影并同期行心肺运动试验测试的患者,其中冠脉临界病变组184例,非冠心病组73例。比较两组症状、基线资料、实验室和超声心动图数据、心肺运动试验结果,并观察1年内主要心血管事件。结果与非冠心病组相比,冠脉临界病变组男性比例显著升高(χ^(2)=15.857,P<0.001),有吸烟史(χ^(2)=9.067,P=0.003)、高血压病史(χ^(2)=15.087,P<0.001)、高脂血症病史(χ^(2)=13.507,P<0.001)的比例明显升高;糖化血红蛋白(Z=2.431,P=0.015)和超敏C-反应蛋白(Z=2.108,P=0.035)水平偏高;达到无氧阈比例明显偏低(χ^(2)=10.702,P=0.001);无氧阈时的心率和呼吸交换率降低(Z>2.156,P<0.05);两组1年后主要心血管事件发生率无显著性差异(P=1.000)。结论冠脉临界病变患者心肺功能有所降低,应控制吸烟、高血压、高脂血症、糖尿病等危险因素。Objective To review the clinical characteristics and capacity of cardiopulmonary exercise test in patients with intermediate coronary stenosis.Methods From January,2015 to January,2020,the patients underwent coronary angiography and cardiopulmonary exercise test in Beijing Bo’ai Hospital were divided into intermediate coronary stenosis group(n=184)and non-coronary heart disease group(n=73).Symptoms,general information,laboratory and echocardiography information,results of cardiopulmonary exercise test were compared between two groups,and the main cardiovascular events during a year were observed.Results The proportion of male(χ^(2)=15.857,P<0.001),smoking history(χ^(2)=9.067,P=0.003),hypertension history(χ^(2)=15.087,P<0.001)and hyperlipidemia history(χ^(2)=13.507,P<0.001)were more,and the level of hemoglobin A1c(Z=2.431,P=0.015)and high sensitivity C-reactive protein(Z=2.108,P=0.035)were higher in the intermediate coronary stenosis group,while less of them could reach anaerobic threshold(χ^(2)=10.702,P=0.001).The heard rate and respiratory exchange rate as anaerobic threshold decreased in the intermediate coronary stenosis group(Z>2.156,P<0.05).There was no significant difference in main cardiovascular events between the two groups within a year(P=1.000).Conclusion Cardiopulmonary capacity has been impaired in patients with intermediate coronary stenosis,who need to pay attention to the risk factors such as smoking,diabetes mellitus,hypertension and hyperlipidemia.

关 键 词：冠状动脉临界病变 心肺运动试验 心率 摄氧量 无氧阈 

分 类 号：R541.4[医药卫生—心血管疾病]