老年前期和老年期正常人的运动心肺功能评测对心脏功能危险分层的意义

Evaluation of cardiopulmonary function and its meaning for heart function risk stratification in healthy people at presenior and geriatric period

目的:对老年前期和老年期正常人进行运动心肺功能评测,得出心脏功能容量的参考值范围,并对心脏功能容量和年龄的相关关系进行探讨。方法:检测对象来自1998/2002卫生部北京医院预防保健科、公安部和外交部老干部局。纳入标准:来自北京地区;年龄在45岁以上;无冠心病和原发性高血压病史;能按规定达到运动终点。排除标准:除外呼吸系统,血液系统疾患及甲状腺功能亢进等代谢性疾病。纳入分析的正常人共84例,其中男50例,女34例;老年前期组42例,其中男25例,女17例,年龄45～59岁;老年组42例,男25例,女17例,年龄在60岁以上。采用功率自行车作功,通过心肺运动试验,测定安静、运动期及恢复期的心率、血压、心电图和气体代谢指标。结果:①老年男性的运动时间、运动中最大心率(maximalheartrate,HRmax)、心率增值、心率-血压双乘积(rate-pressureproduct,RPP)、最大氧耗量(maximaloxygenconsumption,VO2max)、二氧化碳排出量(CO2output,VCO2)及每分通气量(minuteventilation,VE)等指标均明显低于老年前期组(t=4.26～6.78,P<0.01);老年女性的运动时间、ST段压低、最大心率、心率增值明显低于老年前期组(t=2.33～2.59,P<0.05)。②心脏功能容量在男性两年龄组间的差异非常显著(t=3.48,P<0.01)。

AIM:To evaluate the cardiopulmonary function and study the low limit value of cardiac functional capacity(CFC) and the correlation between CFC and age in presenior and geriatric healthy people. METHODS:The detected object was chosen from the Department of Prevention and Health Protection,Beijing Hospital, Retired Cadre Bureau of Ministry of Foreign Affairs and Police, from 1998 to 2002.Including criteria:coming from Beijing Region; above 45 years old;without coronary heart disease and high blood pressure;arriving the termination according to the request.Excluding criteria:with the disease of external respiration,blood system and sthenic function of hypothyroid.Totally 84 healthy persons were involved,among whom 50 males and 34 females;there were 42 persons aged from 45 to 59 in the presenior period,among whom 25 males and 17 females;Cardiopulmonary exercise testing was performed with ergometer bicycle.Indexes of heart rate,blood pressure,cardiogram, oxygen consumption and carbon dioxide production were tested in quiet,exercising and rehabilitation period respectively. RESULTS:①The total exercise time, maximal heart rate(HRmax) the increment of heart rate(ΔHR),rate pressure product(RPP),maximal oxygen consumption(VO2max),CO2 output (VCO2) and minute ventilation(VE) in geriatric male people were significantly lower than those in presenior people(t=4.26 to 6.78,P< 0.01).The total exercise time,ST depression,HRmax and ΔHR in geriatric female were significantly lower than those in presenior(t=2.33 to 2.59,P< 0.05).②CFC was significantly different in male between two different age groups (t=3.48, P< 0.01 ) and also different in female(P< 0.05),in the same age group between male and female there were significant difference(t=4.68,5.32,P< 0.001).③CFC had significant negative correlations with age in male and female healthy people(r = -0.617 6, P< 0.001; r=-0.427 3,P< 0.02).④The low limit value of CFC should be: male in presenior ≥7.4 METs,geriatric ≥6.2 METs;female in presenior ≥5.8 METs,geriatric ≥5.2 METs CONCLUSION:CFC has significantly negative correlations with age in presenior and geriatric healthy people; the low limit range of value of CFC should be from 5.2 METs to 7.4 METs.