运动试验后心率恢复与冠心病患者心肺功能及生存质量的相关性研究

关键词：心率恢复  冠心病  心肺功能  生存质量

Keywords:heart rate recovery  coronary heart disease  cardiopulmonary function  quality of life

摘要：

      摘要 目的：探讨心肺运动试验终止2min时的心率恢复情况与冠心病患者心肺功能及生存质量（QOL）的相关性。 方法：纳入87例临床经冠脉造影检查而确诊为冠心病的住院患者，行心肺运动试验评估，按照运动试验终止2min时的心率恢复值（HRR2），将其分为以下两组：①HRR2≥42bpm的正常组35例；②HRR2＜42bpm的异常组52例。比较两组患者的静息心率（RHR）、峰值摄氧量（peak VO2）、无氧阈（AT）、峰值通气量（peak VE）和峰值功率（peak power），以及简明健康量表（SF-36）评分结果。 结果：HRR2正常组冠心病患者的RHR明显高于HRR2正常组患者（P＜0.05）；HRR2异常组冠心病患者运动试验过程中的peak VO2、AT、peak power结果均显著低于HRR2正常组（P＜0.01，P＜0.05，P＜0.05），而两组间peak VE相比则差异无显著性（P＞0.05）；HRR2正常组冠心病患者的SF-36评分显著低于HRR2正常组，主要表现在生理功能（PF）、生理职能（RP）、总体健康（GH）、活力（VT）、社会功能（SF）等5个维度方面。 结论：运动试验后的心率恢复与冠心病患者心肺功能及QOL有一定相关性。心率恢复异常的冠心病患者静息心率水平更高，运动时的心肺储备和有氧代谢能力更差。HRR2可以作为预测冠心病患者心肺功能及QOL的可靠指标。

Abstract:

      Abstract Objective：To determine the correlation between heart rate recovery in 2min after cardio-pulmonary exercise test and cardio-pulmonary function, as well as quality of life(QOL) in patients with coronary heart disease. Method：Eighty-seven patients who have been diagnosed as coronary heart disease(CHD) by coronary angiography were conducted cardiopulmonary exercise test(CPET) evaluation. According to heart rate recovery in 2min(HRR2) results, all the patients were divided into the following two groups: ①35 patients with HRR2≥42bpm in normal group; ②52 patients with HRR2＜42bpm in abnormal group. The results of related indexes of CPET and SF-36 scale scores between the patients in two groups were compared. Result：Compared with normal HRR2 group, resting heart rate was higher significantly in abnormal HRR2 group (P＜0.05); When it came to CPET, the outcomes of peak VO2, anoxia threshold(AT) and peak power were obviously lower in abnormal HRR2 group (P＜0.01, P＜0.05, P＜0.05), while significant difference was't found in peak ventilation (peak VE) (P＞0.05). As well as, the scores of SF-36 in abnormal HRR2 group were lower than that in normal HRR2 group, especially for these 5 aspects: physical functioning(PF), role physical(RP), general health(GH), vitality(VT) and social functioning(SF). Conclusion：The post-exercise heart rate recovery is somehow correlated with cardiopulmonary function and QOL in patients with CHD. Those CHD patients with abnormal HRR have a higher resting heart rate, while possess a worse cardiopulmonary reserve and aerobic metabolism ability when doing exercises. HRR2 can be viewed as a reliable indicator for CHD patients to predict cardiopulmonary function and QOL.