心室按需性起搏对无氧阈和最大氧耗量影响

Effect of VVI Pacing on VO_(2max) and Anearobic Threshold During Cardiopulmonary Exercise Test

采用活动平板和心肺运动试验的方法，评定VVI起搏患者无氧阈和最大氧耗量。受试者40例，分为2组。病窦（SSS）组24人，年龄52．3±10．1岁。三度房室传导阻滞（Ⅲ°A-VB）组16人，年龄53．7±10．7岁。试验仪器包括Case-15活动平板心电图和CPX／MAX心肺运动试验系统。SSS组有8人运动未达到无氧阈，Ⅲ°A-VB组有9人运动未达到无氧阈。SSS组无氧阈的做功53．7±16．3W／min，氧耗量18．25±3．66ml／kg／min；Ⅲ°A-VB组无氧阈时的做功21．7±14．4W／min，氧耗量6．58±1．71ml／kg／min。极量运动时，SSS组的最大氧耗量26．20±8．33ml／kg／min，最大做功110±20W／min。Ⅲ°A－VB组最大氧耗量17．38±4．48ml／kg／min，最大做功886±16W／min。SSS组能够承受7METS的最大运动负荷。Ⅲ°A-VB组的最大运动负荷5METS。在进行康复训练时，SSS患者开始康复训练的运动强度5METS。Ⅲ°A-VB阻滞病人的康复训练应从2METS开始。

VO2max and anearobic threshold are golden standards for evaluating cardiac function and work ability. In Order to explore the effects of VVI pacing on VO2max and anearobic threshold, cardiopulmonary exercise test by treadmill on forty patients were performed. The patients were divided into two groups: the sick sinus syndrome (SSS) group (24 patients, aged 52. 3±10. 1) and the Ⅲ°atri oventricular block (Ⅲ°A-VB) group (16 patients,mean age 53. 7 ± 10. 7). In SSS group, eight patients' work time didn't attain the anearobic threshold. and in group of Ⅲ°A-VB, nine patient's work time didn' t attain anearobic threshold either. The patients of SSS group have greater VO2max, ane arobic threshold and work capacity than those of Ⅲ°A-VB group. The SSS group's anearobic thresholds are as follows; VO2AT 18. 25 ± 3. 66 ml/kg/min, work capacity 53. 7 ± 16. 3 W/min and in group Ⅲ°A-VB, VO2AT6. 58 ± 1. 71 ml/kg/min, work capacity 21. 7 ± 14. 44 W/min. When they reached maximal exercise, VO2max is 26. 2 ± 8. 33 ml/kg/min and work capacity is 110 ± 20 W/min in group SSS and VO2max and work capacity in group Ⅲ°A-VB are 17. 38 ± 4. 48 ml/kg/min and 88. 6 W/min. (P<0. 05) SSS group has greater anearobic threshold and aerobic capacity than that of Ⅲ°A - VB group with VVI pacing.