【摘要】 目的:通过平板运动试验对205例老年冠心病急性心肌梗塞(AMI)患者进行康复评定,以区分低危、中危、高危病人,制定相应的运动处方康复方案。方法:从临床上收集的符合研究要求的病例205例,分为介入组(79例)和药物溶栓组(126例),在病情稳定后3～6月行运动平板试验检查。电脑系统自动描记并分析12导联的心率、ST变化的各种数据。结果:较之药物溶栓组,介入组运动试验阳性病例所占比例明显降低(32.9%∶73%),ST段下移最大幅度降低[(0.12±0.06)mV∶(0.17±0.08)mV],总的运动时间延长[(9.2±2.3)min∶(7.2±2.4)min],P均<0.01,最大运动负荷增加[(8.7±2.5)METs∶(6.5±2.6)METs,P<0.05]。试验结果评定介入组高危2例,中危9例,低危68例,显著优于药物及溶栓组(依次为26,64,36例,P<0.001)。结论:介入治疗AMI后运动平板试验各参数均比药物溶栓组有明显改善,说明利用平板试验可对患者进行康复评定,以便制定合适的康复治疗方案。更多还原

【Abstract】 Objective:To investigate the value of submaximal exercise test in aged patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI) or thrombolysis.Methods:Two hundred and five aged patients with AMI were included in this study,of which 79 patients received PCI and 126 patients received thrombolysis.A submaximal exercise test was performed at 3 to 6 months after PCI or thrombolysis.Heart rate and changes of ST per minute were automatically traced and analyzed by computer.Results: Compared with the thrombolysis group,the exercise test positive patients decreased(73%∶32.9%,P<0.01),the maximum range of ST segment depression decreased [(0.12±0.06)mV∶(0.17±0.08) mV,P<0.01],the total exercise time and the maximum exercise load increased [(9.2±2.3) min∶(7.2±2.4) min,P<0.01,(8.7±2.5)METs∶(6.5±2.6) METs,P<0.05] in PCI group.Moreover,two patients were high-risk,nine were middle-risk,and 68 patients were low-risk in PCI group.The risk degree of PCI group was lower than that of thrombolysis group(P<0.05).Conclusion:The result indicated that PCI patients possess better effect than thrombolysis therapy.Furthermore,the submaximal exercise test can classify the patients with AMI into low-,mid-,or high-risk level,and provide a reference to make corresponding exercise prescriptions for such patients.更多还原