基于心电图ST段下压值建立56~65岁运动中心血管风险预测方法的研究  

A Study on the Prediction Method for Cardiovascular Risk During Exercise in People Aged 56 to 65 Years

作　　者：苏浩[1] 芦建东 刘馨鸿 陈书宁 刘敬祺 SU Hao;LU Jiandong;LIU Xinhong;CHEN Shuning;LIU Jingqi(School of Kinesiology,Beijing Sport University,Beijing 100084,China)

机构地区：[1]北京体育大学运动人体科学学院,北京100084

出　　处：《北京体育大学学报》2022年第10期128-140,共13页Journal of Beijing Sport University

基　　金：国家重点研发计划项目“提高运动健身效果的关键因素与健身指导方案”(项目编号:2018YFC2000603)。

摘　　要：旨在分析56~65岁人群运动中的心电图ST段下压值与形态学指标,生理、生化指标以及体力活动水平之间的相关性,探究导致上述人群运动中心血管风险发生的相关因素,构建56~65岁人群前置运动风险判别公式与运动风险预测公式,为预防上述人群在运动中出现心血管风险提供一定的理论参考。共计纳入126名受试者。基础测试在清晨进行,受试者需空腹12 h以上,进行生理生化指标的测量。生化指标包括血脂四项和心肌酶系等。生理指标包括颈动脉中层厚度和脉搏波传导速度等。运动测试要求受试者进行功率自行车递增负荷测试,全程通过气体代谢仪记录其呼吸数据,通过12导心电测试仪监控动态心电图的变化。运动中是否出现心血管风险判定标准为运动中心电图ST段下压值≥0.1且持续超过1 min。通过典型相关分析探究运动中各组运动中心电图ST段下压值相关性较高的指标,并通过贝叶斯判别分析和多元回归分析构建前置运动中心血管风险判别公式与运动中心血管风险预测公式。最后使用Kappa一致性检验验证本实验建立的前置运动风险判别公式的应用效果,使用组内相关系数验证运动风险预测公式。结果:运动中心电图无异常组ST段下压值与LDH和PBF显著相关,运动中心电图异常组ST段下压值与LDL、PA和PWV显著相关,基于此通过贝叶斯判别分析构建了预测公式。并将第2次招募的50人代入构建的预测公式,运动中心电图异常人群运动风险预测公式与心电图无异常人群运动风险预测公式一致性检验结果的ICC值分别为0.828与0.475,均大于0.4,并且显著性检验结果P值分别为0.003与0.002,小于0.05,心电图无异常人群运动中心血管风险预测公式可用。结论:56~65岁人群运动中的心血管风险程度可由反映血脂代谢和血管硬化程度及体力活动水平的指标构建的心血管风险预测公式进行�Objective:this study aims to analyze the correlation between ECG ST-segment subtension values duringexercise and physiological indicators such as morphological indicators,vascular stiffness,cardiovascular functionand obesity level,and biochemical indicators such as lipid metabolism and cardiac injury level as well as physicalactivity level in people aged 56 to 65 years.The study was conducted to investigate the factors that contribute to theoccurrence of cardiovascular risk during exercise in the above-mentioned group,and to construct a formula for identifying the risk of exercise and a formula for predicting the risk of exercise in the group.Methods:a total of 126 subjects were enrolled.The basic test was performed in the early morning,with subjects fasting for at least 12 hours,and physiological and biochemical parameters were measured.The physiological and biochemical parameters included the four lipid panels and the cardiac enzyme system.Physiological parameters included CIMT and PWV,etc.The exercise test required subjects to perform a power cycle incremental load test,record their respiratory data via a gas metabolizer throughout the process,and monitor changes in the dynamic ECG via a 12-lead ECG tester.The cardiovascular risk during exercise was determined by the presence of an ECG ST-segment subtension value of≥0.1 for more than 1 min.The typical correlation analysis was used to investigate the indicators of high correlation between the ECG ST-segment subtension values of each group during exercise,and the predictive formula for cardiovascular risk during exercise was constructed by Bayesian discriminant analysis and multiple regression analysis for different age groups respectively.Finally,the Kappa consistency test was used to validate the application of the antecedent exercise risk discrimination formula established in this experiment,and the intra-group correlation coefficient was used to validate the exercise risk prediction formula.Results:the incidence of cardiovascular risk in the 56 to 65age gr

关 键 词：运动中 心血管风险 心电图异常 运动风险 预测公式 

分 类 号：G804[文化科学—运动人体科学]