Bakke E F, Hisdal J, Jørgensen J J, Kroese A, Stranden E
Department of Vascular Diagnosis and Research, Oslo Vascular Centre, Aker University Hospital, University of Oslo, Oslo, Norway.
Eur J Vasc Endovasc Surg. 2007 Jan;33(1):20-5. doi: 10.1016/j.ejvs.2006.06.023. Epub 2006 Aug 23.
The purpose of this study was to compare the circulatory responses to walking in patients with peripheral atherosclerotic disease (PAD) and healthy controls.
The participants were eleven patients with diagnosed PAD, and a control group of six healthy age-matched adults. Blood pressure, heart rate (HR), and acral skin perfusion were recorded continuously before, during and after a walking exercise on a treadmill.
The patients walked to maximum claudication distance (MCD) on a treadmill, median walking distance 103 (34-223) metres [median (range)], at 3.3 (1.0-4.5) km/h. There was a steep increase in HR and mean arterial pressure (MAP) while the patients were walking. At claudication the median rise in MAP was 46.6 (10.3-61.3) mmHg, systolic blood pressure (SP) increased by 84.9 (31.4-124.9) mmHg, and diastolic blood pressure (DP) by 21.7 (-2.1-31.7) mmHg. HR increased by 34.9 (12.9-48.1) beats/min. The control group walked for 5 minutes at 3.2 (3.0-3.3) km/h. In the control group the blood pressure initially increased moderately but stabilised thereafter. Median rise in MAP during walking was 8.5 (5.6-14.6) mmHg, SP increased by 30.9 (6.6-41.5) mmHg, and DP was reduced by -1.4 (-5.4-1.5) mmHg. HR increased by 27.1 (18.8-34.9) beats/min. We found no significant differences in acral skin perfusion during walking exercise between the patients and control group.
In patients with PAD, blood pressure increased continuously and significantly when walking to MCD (dynamic exercise). The level of increase in blood pressure was similar to that caused in response to isometric exercise.
本研究旨在比较外周动脉粥样硬化疾病（PAD）患者与健康对照者在步行时的循环反应。
参与者为11名确诊为PAD的患者以及一组由6名年龄匹配的健康成年人组成的对照组。在跑步机上进行步行运动前、运动期间和运动后，连续记录血压、心率（HR）和肢端皮肤灌注情况。
患者在跑步机上行走至最大跛行距离（MCD），中位行走距离为103（34 - 223）米[中位数（范围）]，速度为3.3（1.0 - 4.5）千米/小时。患者行走时HR和平均动脉压（MAP）急剧上升。在出现跛行时，MAP的中位上升幅度为46.6（10.3 - 61.3）毫米汞柱，收缩压（SP）升高84.9（31.4 - 124.9）毫米汞柱，舒张压（DP）升高21.7（ - 2.1 - 31.7）毫米汞柱。HR增加34.9（12.9 - 48.1）次/分钟。对照组以3.2（3.0 - 3.3）千米/小时的速度行走5分钟。在对照组中，血压最初适度升高，但随后稳定下来。行走期间MAP的中位上升幅度为8.5（5.6 - 14.6）毫米汞柱，SP升高30.9（6.6 - 41.5）毫米汞柱，DP降低 - 1.4（ - 5.4 - 1.5）毫米汞柱。HR增加27.1（18.8 - 34.9）次/分钟。我们发现患者与对照组在步行运动期间肢端皮肤灌注无显著差异。
在PAD患者中，步行至MCD（动态运动）时血压持续且显著升高。血压升高水平与等长运动引起的升高水平相似。
