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平板运动试验中高血压和冠心病患者运动时间及运动血压的特点

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摘要:

目的 观察冠状动脉粥样硬化性心脏病(冠心病)及高血压患者平板运动试验中运动时间及血压变化的特点,并分析冠状动脉(冠脉)狭窄程度与运动时间及血压变化的关系。方法 选取2018年1月至2020年8月于郑州大学第一附属医院行平板运动试验的患者310例,其中105例患者行冠脉CTA,195例患者行冠脉造影,根据造影结果和病史分为四组,A组(对照组):正常人群,62例;B组(单纯高血压组),53例;C组(冠心病不合并高血压组),80例;D组(冠心病合并高血压组)115例;记录患者运动试验前静息血压,运动中峰值血压,恢复6 min血压及运动时间,计算C、D两组改良Gensini评分,并分析该评分与运动时间、峰值血压及恢复6 min后血压的关系。结果 C组运动时间最短,与其他各组比较差异均有统计学意义(P<0.05);B组运动时间最长,与C组及D组比较差异均有统计学意义(P<0.05)。B组,C组及D组静息血压,峰值血压和恢复6 min后血压均较对照组明显升高,且具有统计学意义(P<0.05)。C组和D组的改良Gensini评分与运动时间、峰值收缩压,舒张压,恢复6 min后收缩压,舒张压均无明显相关性(相关系数r<0.15,P>0.05)。结论 冠心病患者运动耐力降低;高血压,冠心病患者的血压在运动和恢复中均较正常人明显升高;冠脉狭窄程度与运动时间及运动血压变化无明显相关性。

Abstract:

Objective To observe the blood pressure response and exercising time during the treadmill exercise test in patients with coronary heart disease and analyze the relationship between the degree of coronary stenosis and the blood pressure response and exercising time. Methods A total of 310 patients who underwent TET from January 2018 to August 2020 in the First Affiliated Hospital of Zhengzhou University were collected, divided into A group (control group, n=62), B group(hypertension group, n=53), C group (non-hypertension complex CHD, n=80), D group (hypertension complicated CHD, n=115), according to history and coronary angiography. Recorded rest, peak, recovery blood pressure, and exercising time; calculated modified Gensini score and analyzed the correlation between the score and exercising time, peak, recovery blood pressure. Results Group C showed the shortest exercise time compared with all other groups (P<0.05). Group B showed the longest exercise time compared with groups C and D (P<0.05). After 6 min of recovery in groups B, C, and D, the resting BP, peak BP, and BP were significantly higher than those in the control group and were statistically significant (P<0.05). The modified Gensini scores of groups C and D were not significantly correlated with exercise time, peak systolic and diastolic blood pressure, or systolic and diastolic blood pressure after 6 minutes of recovery (correlation coefficient R-value<0.15, P>0.05). Conclusion Reduced exercise tolerance in patients with coronary heart disease; Hypertension, the blood pressure of patients with coronary heart disease is significantly higher than average in both exercise and recovery; There was no significant correlation between the degree of coronary stenosis and exercise time or exercise BP change.

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