【摘要】 目的 :通过运动负荷试验评价经皮腔内冠状动脉成形术 ( PTCA)效果 ,为患者进一步康复提供参考。方法 :对行常规 PTCA的 18例患者分别于 PTCA前后 1周及随访期行亚极量踏车运动试验 ,监测血压、心率、心电图变化及最大氧耗量 ( VO2 max)等参数。结果 :PTCA后运动所达到的最大心率 ( HRmax)较术前明显提高 ( 14 3.1比 135 .1次 /min,P<0 .0 5 ) ,最大运动量明显提高 ( 7.11比6.5 3METS,P <0 .0 1) ,运动诱发的心电图相应导联 S- T段压低明显改善 ( - 1.39比 - 0 .85 mm,P <0 .0 0 2 ) ,运动中每分钟通气量 ( VE)、二氧化碳的产生 ( VCO2 )均明显增加 (分别为 5 5 .7比 5 1.0L/min,P<0 .0 2及 1.87比 1.76L/min,P<0 .0 2 )。与术后比较 ,随访期运动时间、最大运动量、VE、VCO2 及 VO2 均有明显提高 (分别 P <0 .0 0 5 ,P <0 .0 2 )。结论 :冠心病患者 PTCA后 VO2 max、HRmax、VE及 VCO2 均明显提高 ,运动诱发的心肌缺血明显改善 ,运动耐量明显增加。术后适当运动可以使以上参数进一步提高更多还原

【Abstract】 Objective:To compare changes of cardiac function in patients after successful PTCA and at follow up.Method:Routine symptom limited submaximal bicycle stress exercise tests were performed before,7 to 10 days and 2 months after successful PTCA. The parameters including blood pressure, heart rate,S T segment changes,maximal oxygen consumption(VO 2max ) and minute ventilation (VE) and maximal production of carbon dioxide (VCO 2) during exercise were monitored during stress test.Result:18 patients with successful PTCA were included in this study.8 patients were single vessel disease,10 patients were two or three vessel disease.The maximal heart rate (HR max ) post PTCA during exercise testing was significantly higher than that pre precedure ( 135.1 vs 143.5 beats/min,P< 0.05 ).Exercise induced maximal S T depression (ST max ) post PTCA was significantly improved (- 1.39 mm vs - 0.85 mm,P< 0.002 ).The maximal work capacity post PTCA significantly increased from 6.53 METS at baseline to 7.11 METS post precedurec (P< 0.01 ).The VE and VCO 2 were all significantly increased when compared to those of baseline ( 55.7 vs 51.0 L/min,P< 0.02 ; 1.87 vs 1.76 L/min, P< 0.05 ,respectively).The parameters of maximal work capacity,exercise time,VE,VCO 2 and VO 2max at 2 months post PTCA were all significantly further increased when compared to those of baseline.Conclusion:The maximal work capacity,HR max ,ST max ,VE and VCO 2 were all significantly increased after successful PTCA,which indicating improvement of cardiac function.Further significant improvements of these parameters after 2 months proper physical exercise at follow up were obtained.更多还原