心音图运动试验量化心功能分级的研究  

Phonocardiogram exercise test and cardiac function classification

作　　者：刘天虎 曾洪燕 袁启远 晏明君 郑关伦 肖守中[2] 

机构地区：[1]郸县人民医院心内科,四川郸县611730 [2]重庆大学生物医学工程系,重庆4400044

出　　处：《心血管康复医学杂志》2004年第2期99-101,118,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：国家自然科学基金部分资助项日(30070211)。

摘　　要：目的:探讨心音图运动试验(PCGET)评估心肌收缩力及心力储备的价值。方法:应用PCGET,把运动后第1心音(s1)幅值与心率的积对安静时S1幅值与心率的积的倍数与6分钟步行距离系数的积,定义为心脏储备指数(CRI)。370位志愿者进行了PCGET,分析不同CRI受试者在纽约心脏病学会心功能(NYHA)分级上的分布。结果:健康和NYHA Ⅰ级的CRI分布于CRI图的高侧;NYHAⅡ、Ⅲ、Ⅳ级的心血管病病人的CRI分布于CRI图的低侧,并且有较好的相关性。CRI、用运动前、后s1幅值计算的心力储备指数(CCRI)与NYHA分级的符合率分别为70.59%与41.76%,二者有显著差异(P<0.005)。结论:CRI可作为心功能分级的客观量化指标之一;且PCGET无创、简便、代价低。Objective: Explore the value of phonocardiogram exercise test (PCGET) to evaluating cardiac contractility. Methods: PCGET was performed in 370 cases. Recording the distance with the six minutes walking test. Cardiac reserve index (CRI) was the multiplication of ratio for amplitude of S1 (PCGET) and heart rate at after exercise and rest and the coefficient of distance with the six minutes walking test. Results: The distribution of subjects with different CRI at NYHA (New York Heart Association) functional classification was that the CRI of healthy persons and the patients with cardiovascular disease at NYHA class I were at high side of diagram CRI; the CRI of patients with cardiovascular disease at NYHA class Ⅱ-Ⅳ were at low side of CRT diagram. The coincidence rate of NYHA and CRI. CCRI (ratio of the amplitude of first heart sound before and after exercise) was 70.59%, 41.76% respectively (P< 0.005). Conclusion: CRI may be an objective and quantitative indicator of cardiac function classification; PCGET is a noninvasive and inexpensive technique to quantitative evaluating cardiac reserve.

关 键 词：心音图 运动试验 心功能分级 心肌收缩力 心力储备 

分 类 号：R540.4[医药卫生—心血管疾病]