冠心病患者运动靶心率的判定与实践

Determination of target heart rate in exercise training for CAD patients and it's practice

目的：研究如何准确判定冠心病人运动靶心率。方法：220例冠心病（CAD）患者（其中心肌梗塞恢复期病人130例）在医疗监护下进行运动训练。156例病人通过分级运动试验确定靶心率（THR）．运动试验的运动终点是出现心绞痛或收缩压＞180mmHg，ST下移或抬高0．2mV，达到最大心率的85％，然后以运动的峰心率的70％～80％为初始靶心率（相当于57％～65％HRmax）；41例不能进行运动试验者以公式（170～180）一年龄之差为THR.靶心率在运动1～3周后进行调整。结果：156例由运动试验确定的靶心率有114例（73％）适应，而41例由公式确定的靶心率适应率仅12．2％。结论：中老年冠心病人适合的靶心率是60％～65％HRmax；科学判定初始靶心率的方法是分级运动试验。

Objective: To Study correctly determination of target heart rate (THR) in exercise training for coronary atherosclerotic heart disease (CAD) patients. Methods: 220 CAD patients (among which 130 patients accompanied by acute myocardial infarction (AMI) in rehabilitation period) were told to take exercise training. 156 patients were performed the grated exercise testing. The end of exercise is angina pectoris occurs or SBP is > 180mmHg, ECG shows that ST segment depression or elevation 0. 2mV, patient's heart rate (HR) reaches 85% HRmax. Since then 70%~80% of peak HR (correspond with 57%~65%HRmax) is taken to be the THR at the begining of the exercise training. 41 patients who can not take exercise testing .the THR were calculated by subtracting the age from 170~ 180. THR was adjusted during the following 1-3 weeks. Results: Among 156 patients who took the grated exercise test, 114 patients (73%) is adaptable to the early determined THR, whereas adaptable percentage in the patients which the THR is calculated through formula, is only 12. 2. Conclusion: For middle and old CAD patients the suitable THR is 60% ~65 % HRmax. The scientific method to determine the THR at the begining of exercise is used by grated esercise testingauthor's address: Qingdao No2 Sanatorium of Jinan Military Region, Qingdao, 266071