平板运动试验后心率恢复异常多囊卵巢综合征患者临床特征研究

Clinical characteristic of abnormal heart rate recovery abnormality after treadmill exercise test in patients with polycystic ovary syndrome

目的探讨平板运动试验后心率恢复异常的多囊卵巢综合征(PCOS)女性的临床特征,提出此类心血管疾病易感人群干预的重点和方向。方法选择平板试验运动阴性PCOS患者50例为病例组,根据患者运动试验停止后心率恢复(HRR)结果分为HRR异常组和HRR正常组,另选同期我院健康体检年龄匹配的健康女性20例为对照组。检测所有受试者睾酮(T),检测空腹血糖(FBG)空腹胰岛素(FINS)水平并计算胰岛素抵抗指数HOMA-IR。比较各组平板运动试验结果并使用我科研发的糖尿病/肥胖综合评估与康复处方系统调查分析受试者运动行为。结果 HRR异常组PCOS患者表现出显著的中心性肥胖(0.94±0.07vs.0.81±0.07,P<0.05),高雄激素血症(4.34±1.13vs.1.93±0.98,P<0.05),其安静心率显著高于HRR正常组以及对照组而两项乘积(RPP)显著低于另两组(P<0.05)。运动行为方面HRR异常组表现出明显增高的职业活动的比例(0.36±0.16vs.0.20±0.17,P<0.05),而在日常活动以及运动方面三组没有显著差异。结论中心性肥胖、安静心率增高、最大收缩压下降以及职业压力大均是PCOS女性心血管疾病易感人群的显著特征。

Objective：To investigate the clinical features of heart rate recovery （HRR） abnormality after treadmill exercise test in patients with polycystic ovary syndrome （PCOS）,and explore the focus and direction of the intervention for these people.Methods：Fifty PCOS patients who had negative results of treadmill exercise test were selected as study group.The patients were divided into the abnormal HRR group（HRR≤18） and normal HRR group （HRR〉18）.Another 20 healthy women were selected as the control group.All subjects＆#39; testosterone （T）,fasting blood glucose （FBG）,fasting insulin （FINS） levels and insulin resistance index （HOMA-IR） were determined and compared.The exercise behaviors of all subjects were analyzed using the diabetes/ obesity evaluation and rehabilitation system which developed in our department.Results：The PCOS patients in HRR abnormal group showed significant central obesity （0.94±0.07 vs.0.81±0.07,P〈0.05）,hyperandrogenemia （4.34±1.13 vs.1.93±0.98,P〈0.05）,andtheir resting heart rate was significantly higher than the HRR normal group and the control group.Furthermore,the Rate Pressure Product （RPP） in HRR abnormal group was significantly lower than the other two groups （P〈0.05）.HRR abnormal group showed a significant increase in the proportion of professional activities （0.36±0.16 vs.0.20±0.17,P〈0.05）.There was no significant difference in daily activities and exercise among the three groups.Conclusions：Central obesity,increase of resting heart rate,decrease of systolic pressure,and increase of occupational stress are the typical features of cardiovascular diseases susceptible PCOS women.