老年急性心肌梗死患者介入或溶栓治疗后症状限制性运动试验的评估

Evaluation of symptom-limited exercise test in aged patients with acute myocardial infarction post PCI or thrombolysis

目的探讨低危、中危、高危患者的运动处方和康复方案。方法从临床上收集的符合研究要求入选205例,分为2组,其中介入组79例,药物及溶栓126例,在病情稳定后3～6个月行运动平板试验检查。电脑系统自动描记并分析每分钟12导联的心率、斜率、ST变化的各种数据。结果介入组阳性病例所占比例明显降低,ST段下移最大幅度降低,总的运动时间延长,最大运动负荷增加,与溶栓药物组比较差异有统计学意义。试验结果评定高危45例,中危121例,低危39例,并制定相应的运动处方。结论介入治疗AMI后运动平板试验各参数均比药物溶栓组有明显改善,利用平板试验对患者进行康复评定,制订合适的康复治疗方案,能提高患者的生活质量,也可通过控制危险因素而减少复发,降低发病率和死亡率。

Objective A heart stress test was done in 205 aged patients with coronary heart disease and myocardial infarction to assess rehabilitation in order to classify the patients into low, middle and high risk levels, and to make corresponding exercise prescriptions. Methods 205 cases were divided into two groups,79 were in the PCI group, 126 were in the drug thrombolysis group. A heart stress test was done at 3 to 6 months after the stable of patients＇ condition. Heart rate, slope and changes of ST per minute were automatically traced and analyzed by computer. Results It was shown that the proportion of positive cases in PCI group decreased significantly, the maximum range of ST segment depression decreased, the total exercise time was prolonged and the maximum exercise load increased, there was a significant difference compared with the drug thrombolysis group. High risks were 45, middle risks were 121, low risks were 39. Conclusion Observation showed that parameters in the test post PCI were improved than those in drug thrombolysis group.Rehabilitation assessment of the patients with the heart stress test and making proper rehabilitation treatment plan can improve the patients＂ quality of life. It can also reduce the recurrence by the control of risk factors, therefore, decrease the incidence and the mortality rate.