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[冠心病患者在最大负荷平板运动试验和自行车测力计试验中的血流动力学差异]

[Hemodynamic differences between maximal treadmill and bicycle ergometer test in coronary disease].

作者信息

Niederberger M, Gasic S, Kummer F

出版信息

Z Kardiol. 1975 Mar;64(3):239-45.

PMID:1130128
Abstract

9 patients with diagnosis of coronary heart disease (CHD) and typical angina pectoris (AP) were studied by means of a multistage, symptom-limited treadmill test and a similar bicycle ergometer (bike)-test. The sequence of tests was determined by chance. Between the tests, the patients rested one hour. Oxygen uptake (vo2) was determined by the Douglas-bag-method, blood pressures were measured via catheters placed in a pulmonary and a brachial or radial artery, respectively. Cardiac output (Q) was calculated by the direct Fick principle. In all tests, with the exception of one bike-test, all patients were limited by AP. They attained high VO2 (mean 1316 ml/min) on the treadmill (TM) while on the TM their mean arterial blood pressure (BP) was significantly (P greater than 0.05), namely 10 mm Hg as an average, lower. Comparing the final minute -3 of the TM-test with the final minute -1 of the bike-test in 5 patients, we found heart rate (HR), BP and pressure rate product (HR times BP) lower on the TM (P greater than 0.05), whereas VO2 was the same. Patients, whose exercise performance is limited by angina pectoris on bike and TM, achieve higher VO2 on the treadmill, together with lower BP. This may be of clinical importance in exercise-testing and -training of patients with CHD.

摘要

对9例诊断为冠心病(CHD)且有典型心绞痛(AP)的患者进行了多阶段、症状限制的平板运动试验和类似的自行车测力计试验。试验顺序由随机确定。两次试验之间,患者休息1小时。采用道格拉斯袋法测定摄氧量(vo2),分别通过置于肺动脉和肱动脉或桡动脉的导管测量血压。心输出量(Q)采用直接菲克原理计算。在所有试验中,除一次自行车测力计试验外,所有患者均受心绞痛限制。他们在平板运动(TM)时达到了较高的摄氧量(平均1316毫升/分钟),而在平板运动时他们的平均动脉血压(BP)显著降低(P大于0.05),平均降低10毫米汞柱。比较5例患者平板运动试验的最后1分钟-3与自行车测力计试验的最后1分钟-1,我们发现平板运动时心率(HR)、血压和压力心率乘积(HR乘以BP)较低(P大于0.05),而摄氧量相同。在自行车测力计和平板运动中运动能力受心绞痛限制的患者,在平板运动时摄氧量较高,血压较低。这在冠心病患者的运动测试和训练中可能具有临床意义。

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