运动负荷试验指导心肌梗死患者有氧运动的价值

Value of exercise stress test guiding aerobic exercise rehabilitation in patients with myocardial infarction

目的:探讨运动负荷试验指导心肌梗死患者有氧康复运动的价值。方法:选择102例康复期心肌梗死患者,采用随机数字表法分为常规康复组(接受常规康复指导)和有氧运动康复组(在运动负荷试验指导下进行有氧康复运动)各51例。比较两组运动量、血流动力学、心理状态。结果:两组治疗后,运动量:与常规康复组比较,有氧运动康复组运动量[(6.79±0.58)METs比(7.42±0.69)METs]、最大心率[(126.27±5.26)次/min比(138.18±5.81)次/min]、心率血压乘积[(221.87±21.46)比(244.85±23.09)]、运动持续时间[(10.36±1.36)min比(11.18±1.45)min]均明显增加(P<0.05或<0.01);血流动力学参数:与常规康复组比较,有氧运动康复组心输出量[(5.36±0.57)L/min比(5.72±0.68)L/min]、心脏指数[(2.96±0.53)L·min^(-1)·m^(-2)比(3.25±0.52)L·min^(-1)·m^(-2)]、每搏输出量[(73.16±8.47)ml比(78.12±9.14)ml]均明显提高(P均<0.05);心理状态:与常规康复组比较,有氧康复组汉密顿焦虑量表[HAMA,(9.74±3.26)分比(6.35±1.18)分]、汉密顿抑郁量表[HAMD,(14.83±4.58)分比(10.56±3.27)分]评分均明显降低(P均<0.05)。结论:根据运动负荷试验指导有氧康复运动有助于提高运动,改善血流动力学指标,缓解负面情绪,促进患者康复。

Objective.. To explore value of exercise stress test guiding aerobic exercise rehabilitation in patients with myocardial infarction. Methods.. A total of 102 patients with myocardial infarction in recovery were selected. According to random number table, they were randomly and equally divided into routine rehabilitation group （received routine rehabilitation guidance） and aerobic exercise rehabilitation group （received aerobic rehabilitation exercise in guidance of exercise stress test）. Amount of exercise, hemodynamic parameters and psychological state were compared between two groups. Results： After treatment, amount of exercise： compared with routine rehabilitation group, there were significant rise in amount of exercise [ （6. 79 ± 0. 58） METs vs. （7. 42 ± 0. 69） METs], maximum heart rate [ （126. 27 ± 5. 26） beats/min vs. （138. 18 ± 5.81） beats/mini, heart rate blood pressure product [ （221.87 ± 21.46） vs. （244. 85 ± 23.09）] and exercise duration [ （10.36± 1.36） min vs. （11.18±± 1.45） min] in aerobic rehabilitation group, P〈0.05 or d0.01; hemodynamic parameters： compared with routine rehabilitation group, there were significant rise in cardiac output [ （5.36 ± 0.57） L/min vs. （5.72 ± 0. 68） L/mini, cardiac index [ （2. 96± 0. 53） L min^- 1 m^- 2 vs. （3.25 ± 0.52） L min^- m^-2 ], stroke volume [ （73.16 ± 8. 47） ml vs. （78. 12 ± 9. 14） ml] in aerobic exercise rehabilitation group, P〈0. 05 all; psychological state： compared with routine rehabilitation group, there were significant reductions in scores of Hamilton rating scale for anxiety [HAMA, （9.74 ± 3.26） scores vs. （6. 35 ± 1.18） scores] and Hamilton rating scale for depression [HAMD, （14. 83 ± 4. 58） scores vs. （10. 56 ± 3. 27） scores] in aerobic exercise rehabilitation group, P〈0.05 both. Conclusion： Exercise stress test guiding aerobic exercise rehabilitation can help to improve exercise function and hemodynamic indexes, alleviate the negative mood, then promote patients recover.