发病前规律运动对急性心肌梗死患者早期运动耐量的影响

The impact of regular exercise habit on exercise tolerance early after acute myocardial infarction

目的 评价急性ST段抬高心肌梗死（STEMI）患者发病前规律运动与发病后早期峰值摄氧量（VO2peak）的关系。方法 研究入选初次发生急性STEMI并行心肺运动试验的患者239例，回顾性分析患者发病后早期VO2peak的影响因素。结果 128例（53．6％）STEMI患者在发病前有规律运动习惯，经独立样本t检验，规律运动与无规律运动组患者发病后早期VO2peak差异无统计学意义（P=0．317）。经性别、年龄及临床特征等多因素校正，既往规律运动是STEMI后早期VO2peak的独立影响因素（β：1．703，P=0．015）。按年龄分层，结果显示仅40～49岁年龄层患者VO2peak在规律运动和无规律运动两组间差异有统计学意义[（25．0±3．3）m1·kg^-1～·min^-1比（21．3±5．1）m1·kg^-1·min^-1，P=0．004]。结论 规律运动者即使发生STEMI，运动耐量仍优于不运动者，且这种相关性在相对年轻（40～49岁）的患者中最为突出。

Objective To investigate the relationship between regular exercise habit and peak oxygen uptake （VO2peak） early after acute ST-elevation myocardial infarction （STEMI）. Methods A total of 239 patients who underwent cardiopulmonary exercise testing （CPET） early after STEMI in a single exercise laboratory were enrolled. Influencing factors to VO2peak were analyzed retrospectively. Results There were 53.6% patients reported to have regular exercise habits before STEMI. No significant difference between patients with and without exercise habit in VO2 peak early after STEMI （P = 0. 317） were found by t test. After adjusted by risk factors including demographic features, clinical characteristics and cardiovascular, etc, regular exercise habit was an independent factor for VO2peak （β = 1. 703, P = 0. 015 ）. Following age-stratification, the significant difference was found between patients with and without exercise habits in VO2peak only in patients aged between 40-49 years old （P = 0. 004 ）. Conclusions The relationship between regular exercise habit and VO2peak early after STEMI suggests that exercise tolerance of patients with exercise habit will be better than sedentary patients even after STEMI, in particular to patients aged between 4049 years old.