急性心肌梗塞后早期平板运动试验的临床应用

An early clinical application on exercise testing soon after myocardial infarction

１３例急性心肌梗塞患者，年龄５８～７０岁；前壁梗塞５例，下壁梗塞５例，前壁并下壁梗塞３例。３例行溶栓治疗，有１例发病时合并短暂Ⅲ°房室传导阻滞，溶栓后消失，其余患者无并发症，全组病例均进行心肌梗塞Ⅰ期康复治疗，于梗塞后９～２８天行运动试验。１３例中７例呈阳性结果，冠脉造影时呈单支或多支狭窄。５例行ＰＴＣＡ等冠脉成形术。６例运动试验阴性的患者依运动试验结果订出康复运动处方。急性心肌梗塞后无并发症患者早期运动试验既能鉴别高危患者，又可决定患者的出院后体力活动水平，应该成为无并发症的急性心肌梗塞患者的出院前的常规检查。

The heart rate,symptom limited exercise tests were performed in 13 patients under age 70,without clinical complication 9～28 days after acute myocardial infarction(AMI).Seven patients had a positive result.The 7 patients with postive test result exercised for an average of 3.80±1.95 mins,achieved a mean heart rate 106.28±16.26 beat/min,and a mean peak systolic blood pressure of 16.57± 1.86 kPa.The 6 patiens with negative test exercised for an average of 8 09±4.86 mins,achieved a peak heart rate of 132.83±19.23 beat/min,and a mean systolic blood pressure of 20.51±4.34kPa.The 7 patients with positive test result showed stenosis in one to three branches of the coronary artery when recovered from performed coronary arteriography,5 had been treat with percutaneous transluminal coronary angioplasty(PTCA) or stent setting .The 6 patients with negative test result had been given exercise prescription according to the exercise test.It was concluded that exercise test should become a conventional test for patients with AMI before discharging.