Department of Cardiology, Eglin Air Force Base Regional Hospital, Eglin Air Force Base, Florida, USA.
Am J Cardiol. 2010 Mar 1;105(5):672-6. doi: 10.1016/j.amjcard.2009.10.049.
Physical inactivity increases cardiovascular risk. The possible adverse effects of regular motorized scooter use, recently popularized for patients with physical limitations, has not been previously examined. We performed a single-center, retrospective cohort study of 102 consecutive patients who had obtained medical approval for, and subsequently received, a motorized scooter during a 6-year period. The clinical data were collected for the 12 months before and after the intervention. Surveys assessing 11 different facets of health-related quality of life were returned by 28% of patients. The patients receiving a scooter were 68 +/- 19 years old, and 55% were women. The medical indications for scooter use, by decreasing frequency, were disabling arthritis, chronic lung disease, neurologic disorders, and heart failure. Patients returning the surveys estimated scooter use at a median of 4 hours/day, with walking confined to 30 min/day. Despite significant physical and psychological improvements in all quality-of-life categories (p <0.001), the fasting blood glucose increased from 119 +/- 39 to 133 +/- 49 mg/dl (p = 0.009), hemoglobin A1c increased from 6.3 +/- 0.8 to 6.8 +/- 1.2 (p = 0.019), and 18.7% of patients developed diabetes during the follow-up period. No significant changes in blood pressure were noted, although 20% of patients required additional antihypertensive medication. Despite improvements in total and low-density lipoprotein cholesterol over time, 50% of dyslipidemic patients required either an increase medication dose or additional medications during follow-up. In conclusion, interventions, such as scooters, that improve self-perceived quality of life, can have detrimental long-term effects by increasing cardiovascular risk, particularly insulin resistance. Physicians should carefully weigh such risks before approving their use, as well as ensure healthy levels of activity afterward.
身体活动不足会增加心血管风险。最近，对于身体受限的患者来说，常规使用电动代步车的潜在不良影响尚未得到研究。我们进行了一项单中心、回顾性队列研究，纳入了 102 名连续患者，这些患者在 6 年内获得了医疗批准并随后获得了电动代步车。收集了干预前和干预后 12 个月的临床数据。只有 28%的患者返回了评估 11 个不同健康相关生活质量方面的调查。使用代步车的患者年龄为 68 +/- 19 岁，其中 55%为女性。使用代步车的医学指征按频率递减依次为：致残性关节炎、慢性肺部疾病、神经障碍和心力衰竭。返回调查的患者估计代步车的使用时间中位数为每天 4 小时，每天步行限制在 30 分钟以内。尽管所有生活质量类别都有显著的身体和心理改善（p <0.001），但空腹血糖从 119 +/- 39 增加到 133 +/- 49 mg/dl（p = 0.009），血红蛋白 A1c 从 6.3 +/- 0.8 增加到 6.8 +/- 1.2（p = 0.019），18.7%的患者在随访期间患上了糖尿病。虽然 20%的患者需要额外的降压药物，但血压没有明显变化。尽管总胆固醇和低密度脂蛋白胆固醇随时间而改善，但 50%的血脂异常患者在随访期间需要增加药物剂量或增加其他药物。总之，改善自我感知生活质量的干预措施（如代步车）可能会通过增加心血管风险（特别是胰岛素抵抗）而产生不利的长期影响。医生在批准使用之前应仔细权衡这些风险，并确保患者在之后保持健康的活动水平。
