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目的:探讨12周运动心脏康复锻炼对心梗后患者(PMI患者)心脏机能的影响。方法:112名男性PMI患者(均进行了12周运动心脏康复锻炼)进行一次递增负荷运动实验(Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ级负荷跑速分别为1.7、1.7、1.7、2.5、3.5mph;坡度分别为0.5 %、10 %、12 %、14 %,每一级负荷运动3分钟) ,其间记录每级负荷时的VO2、HR、血压和自我用力感觉(RPE) ,计算心率血压乘积(RPP) ,并持续监测12导联心电图(ECG) ,然后对上述指标进行相关分析并建立了用HR和RPE推测VO2和RPP的回归方程。结果:(1)相邻两级负荷间的VO2、HR、RPP、RPE具有显著差异(P<0.01) ;(2)VO2、HR、最大心率百分数( %HRmax)、RPP、ST段水平(ST)和RPE的峰值分别为26.4±7.1ml·kg-1·min-1、126.8±20.3beats·min-1、80.4±12.9 %、209.0±46.3beats·mmHg·100-1、-1.0±0.7mm和14.9±2.1;(3)运动中VO2、HR、%HRmax、RPP、RPE呈高度正相关,它们与ST呈高度负相关(P<0.01或P<0.05) ,建立了用HR和RPE推测VO2和RPP的回归方程。结论:(1)康复锻炼后利用改良Bruce跑台方案进行机能测试有效;(2)12周康复锻炼后,PMI患者进行运动时其强度不宜超过80 %HRmax或RPE不超过15 ;(3)利用本研究建立的预测方程,可在PMI患者康复活动中,根据其心率或RPE变化间接得知其呼吸循环机能的反应和心肌的耗氧状况。
Objective: To investigate the effects of 12-week exercise rehabilitation on cardiac function in patients with myocardial infarction (PMI). Methods: One hundred and twelve male PMI patients (all underwent exercise rehabilitation for 12 weeks) performed an incremental load exercise test (the load running rates of Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ were 1.7, 1.7, 1.7, 2.5 and 3.5 mph (0.5%, 10%, 12%, 14%, and 3 min for each load) were recorded. VO2, HR, blood pressure and RPE were recorded during each load. The product of heart rate and blood pressure RPP). The 12-lead electrocardiogram (ECG) was continuously monitored. Then the correlation analysis was done and the regression equations of VO2 and RPP were deduced with HR and RPE. Results: (1) There were significant differences in VO2, HR, RPP and RPE among adjacent two load groups (P <0.01); (2) VO2, HR,% HRmax, ) And RPE were 26.4 ± 7.1ml · kg -1 · min -1, 126.8 ± 20.3beats · min -1, 80.4 ± 12.9%, 209.0 ± 46.3beats · mmHg · 100-1, -1.0 ± 0.7mm And 14.9 ± 2.1 respectively. (3) There was a highly positive correlation between VO2, HR,% HRmax, RPP and RPE during exercise, which were highly negatively correlated with ST (P <0.01 or P < And RPP regression equation. (2) After 12 weeks of rehabilitation exercise, the strength of PMI patients during exercise should not exceed 80% HRmax or RPE does not exceed 15; (3) The use of The prediction equation established in this study can be used to know the respiratory and circulatory function responses and myocardial oxygen consumption indirectly in the rehabilitation of PMI patients according to their heart rate or RPE changes.