老年冠心病患者对运动负荷的反应

Response of elderly patients with coronary heart disease to treadmill exercise test

目的研究老年冠心病患者对运动负荷的反应及在心脏活动平板运动试验(TET)中参数的变化特征。方法选择经TET并行冠状动脉造影的患者110例。按年龄分为2组:年龄>75岁为老年组(50例),年龄<60岁为对照组(60例)。结果 (1)在TET阳性患者中,增龄在冠心病的诊断价值中差异有统计学意义,老年组冠心病的诊断率83.7%明显高于对照组60.0%(P<0.05);在TET阴性患者中,两组对冠心病的诊断率方面差异无统计学意义(P>0.05)。(2)老年组的总运动时间、峰值心率、ST段下移出现时间均明显小于对照组(P<0.05),而ST段下移幅度及持续时间,两组差异无统计学意义(P>0.05)。结论老年人在TET中对冠心病的诊断率升高;老年冠心病患者对运动负荷的耐受力下降。

Objective To study the response of cardiovascular system to exercise tolerance in patients over 75 years old with coronary heart disease（CHD） and to evaluate the significance of parameters of treadmill exercise test（TET）. Methods 110 patients received TET and coronary artery angiography（CAG）. They were divided into two groups ：The elderly patients group included 50 patients over 75 years of age,and the control group included 60 patients under 60 years. Results （1） With aging, there were difference in diagnosis rate of more CHD patients in positive CHD between the 2 groups in TET （P 〈 0.05） ;but there was no negative TET （P） 0.05）. （2）The parameters of TET for the elderly CHD patients group, including the total exercise time, peak heart rate and the time of onset of ST depression, were lower than those for the control group （P 〈 0.05） ,but there was no significant difference in the extent and duration of ST depression between the two groups （P〉 0.05）. Conclusions TET had higher diagnostic value for CHD in the elderly. The elderly patients with CHD have decreased endurance to exercise test.