运动前收缩压与心肺运动试验心电图阳性结果的关系  

Relationship between pre-exercise systolic blood pressure and positive results of electrocardiogram in cardiopulmonary exercise testing

作　　者：田颖 严连喜 曹华娟 陈法言 王庆路 TIAN Ying;YAN Lianxi;CAO Huajuan;CHEN Fayan;WANG Qinglu(Nanjing Jianye District Shazhou Community Health Service Center,Nanjing 210000,CHINA)

机构地区：[1]南京市建邺区沙洲社区卫生服务中心内科,江苏210000 [2]南京健嘉康复医院内科 [3]南京汉沐嘉中西医结合门诊部中医儿科 [4]南京医科大学附属明基医院康复医学科

出　　处：《江苏医药》2024年第10期1035-1039,共5页Jiangsu Medical Journal

摘　　要：目的探讨运动前收缩压与心肺运动试验(CPET)心电图阳性结果的关系。方法199例成年受试者行CPET,39例心电图阳性结果(A组),160例心电图阴性结果(B组)。记录两组运动前和运动过程中心率、血压、心电图ST段波形及代谢当量变化。采用多因素logistic回归分析心电图阳性结果的独立影响因素,分析运动前收缩压与各临床指标的相关性,并采用ROC曲线评估运动前收缩压对心电图阳性结果的诊断价值。结果与B组相比,A组年龄、运动前收缩压和舒张压以及运动中最大心率、最大收缩压、最大舒张压、最大代谢当量、最大ST段抬高、最大ST段下降和最大ST段改变均增加(P<0.05)。年龄较大、运动中最大心率较高和运动前收缩压较高是CPET心电图阳性结果的独立危险因素(P<0.05)。运动前收缩压与年龄、体重、BMI、体表面积、运动前舒张压以及运动中最大收缩压、最大舒张压、最大ST段抬高、最大ST段改变、最大代谢当量呈正相关(P<0.05),而与运动中最大ST段下降呈负相关(P<0.05)。ROC曲线结果显示,运动前收缩压诊断心电图阳性结果的AUC为0.690[95%CI(0.601~0.780),P<0.01],取最佳诊断界值为115.50mmHg时,其对应的灵敏度和特异度分别为79.5%和53.1%。结论运动前收缩压与CPET心电图阳性结果密切相关。Objective To investigate the correlation between pre-exercise systolic blood pressure and positive results of electrocardiogram in cardiopulmonary exercise testing(CPET).Methods Of 100 adult people received CPET,39 cases had the positive results of electrocardiogram(group A),and 160 cases had the negative results of electrocardiogram(group B).The changes of heart rate,blood pressure,ST-segment waveform and metabolic equivalent before and during CPET were recorded.The independent influencing factors for the positive results of electrocardiogram were analyzed by multivariate logistic regression.The correlation between pre-exercise systolic blood pressure and related clinical indicators was analyzed.The diagnostic value of pre-exercise systolic blood pressure in the positive results of electrocardiogram was evaluated by ROC curve.Results Compared with group B,the age,pre-exercise systolic blood pressure,and maximal heart rate,systolic blood pressure,diastolic blood pressure,metabolic equivalent,ST-segment elevation,ST-segment depression and ST-segment change during the exercise were increased in group A(P<0.05).The increased age,maximal heart rate during the exercise and pre-exercise systolic blood pressure were the independent risk factors for the positive results of electrocardiogram(P<0.05).The pre-exercise systolic blood pressure was positively correlated with the age,body weight,BMI,body surface area,pre-exercise diastolic blood pressure and maximal systolic blood pressure,diastolic blood pressure,ST-segment elevation,ST-segment change and metabolic equivalent during the exercise(P<0.05),but was negatively correlated with the maximal ST-segment depression during the exercise(P<0.05).The AUC value of pre-exercise systolic blood pressure in diagnosing the positive results of electrocardiogram was 0.690[95%CI(0.601~0.780),P<0.01].When taking 115.50mmHg as the cut-off value,the diagnostic sensitivity and specificity were 79.5%and 53.1%,respectively.Conclusion The pre-exercise systolic blood pressure is closely asso

关 键 词：心肺运动试验 收缩压 心电图 

分 类 号：R541[医药卫生—心血管疾病]