40～49岁男性运动中心血管风险预测指标探析

The Preliminary Research on Predictors of Cardiovascular Risk During Exercise for 40 ～ 49 Years Old Men

目的：动态心电监测是评价运动风险的有效方法。但不适合大范围人群采用。通过对运动风险的常见情况sT段异常与相关生理生化指标进行回归分析，探讨运动中sT段异常与安静状态下生理生化指标之间的关联，并尝试利用安静状态下生理生化指标建立40～49岁男性运动风险预测方程。方法：173人（44．0岁±3．5岁）进行递增负荷运动，测试心肺耐力与动态心电；运动中V1至V6 sT段降低≥0．1 mV作为sT段降低异常标准；通过多元回归和逐步回归分析sT段异常与安静生理、生化指标之间的关联，建立sT段异常预测公式。结果：1）运动中16％的受试者在心肺耐力水平均不超过34．1 mL／kg／min且运动强度大于等于75％最大摄氧量时出现sT段降低异常；2）受试者心肺耐力水平由34．1 ml／kg／min降至31．9ml/kg／min，运动中sT段降低异常发生率由1．2％增加至5．2％。3）sT段异常值与HDL-c、OP以及DBP存在显著关联（P〈0．05）；利用相关生理生化指标建立了运动中心电sT段降低异常预测公式。结论：1）40-49岁男性心肺耐力水平低于34．1 mL/kg／min，在运动强度大于等于75％最大摄氧量时运动中心血管风险增加。2）高密度脂蛋白胆固醇、安静状态下舒张压和大脑疲劳程度OP 3项指标可以预测40-49岁男性运动中的心血管风险。

Purpose： Dynamic ECG monitor can evaluate cardiovascular risk effectively during exercise, but it＇ s not suitable for large population. This study detected the relationship between abnormal decline of ST segment in ECG during exercise and physiological and biochemical indexes by regression analysis, and tried to build predictor equation of cardiovascular risk for 40 - 49 years old men. Methods ： One hundred seventy-three male people （44.0 ±3.5 yrs） participated in graded exercise test to test cardiorespiratory fitness, and to be monitored by ECG. The standard of ST segment abnormal decline is that ST segment of V1 - V6 is over 0. 1 mV during exercise. The statistics analyses of multiple regression and stepwise regression were used to detect the relationship between abnormal decline of ST segment and physiological and biochemical indexes, and built predictor equation of cardiovascular risk, Results： 1 ） Sixteen percent of volunteers, whose VO2max are not more than 34. 1 mL/kg/min, have cardiac ST segment abnormal decline when exercise intensity is over 75% VO2max. 2） When VO2max decreases from 34. 1 mL/kg/min to 3t. 9 0aL/kg/min, the abnormal decline rate of ST segment is increased from 1.2% to 5.2%. 3） The abnormal value of ST egment is related to HDL-c, OP and DBP （P 〈 0.05 ）. The predictor equation of ST segment abnormal decline is built based on physiological and biochemical indexes. Conclusion： 1 ） The VO2max of 40 - 49 years old male people is lower than 34. 1 mL/kg/min, and their cardiovascular risk is increased when exercise intensity is over 75% VO2max. 2） Three indexes, HDL-c, OP and DBP, can predict cardiovascular riskduring exercise for 40 -49 years old men.