老年高血压病人中等强度运动平板试验的血压应答  

Blood pressure responses to moderate-intensity treadmill exercise test in elderly patients with hypertension

作　　者：余萍[1] 汤瑶[1] 季鹏[1] 王萍[1] YU Ping;TANG Yao;JI Peng;WANG Ping(Department of Cardiac Rehabilitation,Jiangsu Province Official Hospital,Nanjing 210024,China)

机构地区：[1]江苏省省级机关医院心脏康复门诊,江苏省南京市210024

出　　处：《实用老年医学》2023年第11期1130-1133,共4页Practical Geriatrics

基　　金：南京体育学院运动与健康工程协同创新项目(JSCIC-MP21001)。

摘　　要：目的 观察老年高血压病人对中等强度平板运动试验(treadmill exercise test, TET)的血压反应,并找出能诊断高血压的中等强度运动血压水平。方法 选取2019年12月至2022年9月在江苏省省级机关医院心脏康复门诊进行TET的病人208例,根据血压水平分为高血压组112例,正常血压组96例,记录并比较2组病人在TET期间的血压变化,并采用多因素Logistic回归分析TET中血压变化与高血压的关系,绘制ROC曲线分析诊断高血压的TET血压水平。结果 高血压组和正常血压组病人TET中Bruce方案第一、二阶段的血压及峰值SBP差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,Bruce第二阶段的SBP水平与高血压独立相关(OR=1.102,95%CI:1.037~1.172,P<0.01)。ROC曲线分析显示,以TET中Bruce方案第二阶段的SBP诊断血压的最佳截断值为168.5 mmHg,此时的敏感度为86.4%,特异度为81.8%,AUC为0.876。结论 老年高血压病人TET中血压反应显著高于正常血压的病人,当TET中Bruce方案第二阶段SBP≥168.5 mmHg时需考虑该老年病人存在静息血压控制不佳的可能。Objective To explore the blood pressure(BP)responses to moderate-intensity treadmill exercise test(TET)in the elderly patients with hypertension,and to find out the cutoff value of BP in moderate-intensity exercise for diagnosis of hypertension.Methods A total of 208 patients who underwent TET in the cardiac rehabilitation clinic of the Jiangsu Province Official Hospital from March 2021 to September 2022 were selected and divided into hypertension group(112 cases)and normal BP group(96 cases).The levels of BP during TET in the two groups were recorded and compared.Multivariate Logistic regression was used to analyze the influencing factors of hypertension.Receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to analyze the moderate-intensity exercise BP value for diagnosis of hypertension.Results There were significant differences in the levels of BP and peak systolic blood pressure(SBP)at stage 1 and 2 of Bruce protocol in TET between hypertension group and normal BP group(P<0.05).Multivariate Logistic regression showed that the level of SBP at stage 2 of Bruce protocol was independently associated with hypertension.The ROC curve showed that the cut-off value of stage 2 SBP for diagnosis of hypertension was 168.5 mmHg,with a sensitivity of 86.4%,a specificity of 81.8%,an AUC of 0.876.Conclusions In the elderly hypertensive patients,the BP response in TET is significantly higher than that in the patients with normal BP.When the stage 2 SBP of Bruce protocol in TET is≥168.5 mmHg,the possibility of hypertension in this elderly patient should be considered.

关 键 词：血压 平板运动试验 高血压 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]