摘要
目的回顾性分析老年女性冠心病患者心肺运动试验(CPET)相关数据,探讨老年女性冠心病患者CPET的临床特点。方法选取自2015年4月至2016年4月于沈阳军区总医院心血管内科住院治疗的诊断为冠心病并进行CPET测试的老年(年龄≥65岁)患者470例,其中,女性患者127例为老年女性组,男性患者343例为老年男性组。记录并比较两组患者临床资料,并通过瑞士Schiller CS-200心肺运动试验系统对两组患者进行测试,在静息状态下测定肺功能、心电图,而后连续动态监测记录进出气流、O2浓度、CO2浓度、全导联心电图、血压及血氧饱和度的实时变化。对两组患者CPET检测方案及结果进行比较。结果老年女性组运动递增功率、运动持续时间均低于老年男性组,而因疲劳终止患者比例、无氧阈心率高于老年男性组,差异均有统计学意义(P <0. 05)。危险分层中,两组高危人群比例比较,差异无统计学意义(P> 0. 05),且均无恶性心律失常及死亡等不良事件发生。老年女性组无氧阈摄氧量、无氧阈公斤摄氧量、无氧阈负荷、峰值摄氧量、峰值公斤摄氧量、峰值负荷、用力肺活量(L)、第1秒用力呼气量(L)、最大通气量均低于老年男性组,而呼吸频率高于老年男性组,差异均有统计学意义(P <0. 05)。结论老年女性冠心病患者因心功能较差、高血压比例较高,导致在CPET中运动持续时间缩短、运动耐量明显下降,呼吸储备和呼吸功能也明显下降,需引起高度重视。
Objective To analyze the cardiopulmonary exercise testing(CPET)data of elderly female patients with coronary heart disease(CHD)and to summarize the clinical characteristics of the patients with acute coronary syndrome.Methods A retrospective study was performed on 470 cases of elderly CHD patients who were admitted and underwent CEPT(aged more than 65 years old)from April 2015 to April 2016.Among the 470 patients,127 patients were elderly female CHD patients and 343 patients were elderly male CHD patients.The clinical data of the two groups were recorded and compared,and the two groups were tested through the Schiller CS-200 cardiopulmonary exercise test system in Switzerland.Pulmonary function and ecg were measured under resting state,and then real-time changes of air flow in and out,O 2 concentration,CO 2 concentration,full-lead ecg,blood pressure and oxygen saturation were monitored continuously and dynamically.CPET detection scheme and results were compared between the two groups.Results The increasing power of exercise and duration of exercise in the elderly female group were lower than that in the elderly male group,while the proportion of patients with fatigue termination and the anaerobic threshold heart rate were higher than that in the elderly male group,and the differences were statistically significant(P<0.05).In risk stratification,the proportion of high-risk groups in the two groups was compared without statistically significant difference(P>0.05),and no adverse events such as malignant arrhythmia and death occurred.The anaerobic threshold oxygen uptake,anaerobic threshold kg oxygen uptake,anaerobic threshold,peak oxygen uptake,peak kg oxygen uptake,peak load,forced lung capacity,forced expiratory volume in the first second,maximum gas uptake in the elderly female group were all lower than those in the elderly male group,the breathing frequency was higher than that in the elderly male group,and the difference was statistically significant(P<0.05).Conclusion Elderly female patients with CHD due to po
作者
张剑
孙毅
贺靖斐
张伊
梁延春
韩雅玲
ZHANG Jian;SUN Yi;HE Jing-fei;ZHANG Yi;LIANG Yan-chun;HAN Ya-ling(Department of Cardiology,Cardiovascular Research Institute of PLA,The General Hospital of Shenyang Military Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2018年第10期1139-1142,共4页
Clinical Journal of Medical Officers
