β-受体阻断剂对心脏康复跑台运动时机能、生理、临床和感觉反应的影响

Effects of Beta-blockade on Functional, Physiological,Clinical and Perceptual Response to Treadmill Exercise in Cardiac Rehabilitation

目的:测试服用和未服用β-受体阻断剂的心梗后患者(PMIP)在跑台运动中其功能、生理、临床及自我感觉方面的反应。方法:46名服用β-受体阻断剂的男性PMIP和55名未服用β-受体阻断剂的男性PMIP进行递增负荷运动实验,其间记录每级负荷时的摄氧量(VO2)、心率(HR)、血压和自我用力感觉(RPE),并持续监测12导联心电图(ECG)。结果:服用β-受体阻断剂的患者其安静时和运动中的HR、最大心率百分比(%HRmax)及心率—血压乘积(RPP)显著低于未服用β-受体阻断剂的患者(P<0.01)。运动中,服用β-受体阻断剂的患者有59%能够完成改良布鲁斯跑台方案的第级运动,而在未服用β-受体阻断剂的患者中仅有49%能完成这一负荷。两组在运动中各级别VO2、RPE及ST段下移无显著性差异。结论:由β受体阻断剂所致的HR降低并没有直接地影响到氧利用和代谢机能。

The purpose of this study was to examine the functional, physiological, clinical and perceptual responses during treadmill exercise of post myocardial infarction patients （PMIP） with and without beta-blockade therapy. Forty-six male recent PMIP with beta blockade therapy and 55 male recent PMIP without beta blockade therapy performed a graded exercise test. During which, the oxygen uptake （VO2）, heart rate （HR）, blood pressure and ratings of perceived exertion （RPE） were recorded,and a 12 lead electrocardiogram （ECG） was monitored continuously. The result showed that patients using beta-blockade had a significantly lower（P〈 0.01） HR, percentage of maximum heart rate （%HRmax） and rate-pressure product （RPP） both at rest and during exercise. During exercise 59% of patients using beta-blockade completed stage IV of the modified Bruce treadmill protocol ,whereas in the non-blockade group,only 49% of the patients achieved this stage. There was a non-significant difference between the two groups in terms of VO2, RPE and ST segment depression at any stage during exercise test. Conclusion：The reduction in HR as a result of beta blockade does not impact directly on all other aspects of metabolism and oxygen utilization.