Svendsen J H, Madsen J K, Saunamäki K I, Grande P, Pedersen F H, Clemmensen P M, Haedersdal C, Granborg J
Medicinsk afdeling B, Rigshospitalet, København.
Ugeskr Laeger. 1994 Jul 25;156(30):4352-5.
Exercise test variables, such as an impaired heart rate response, are known to be related to left ventricular function and patient prognosis following acute myocardial infarction. The present study was performed to compare exercise test variables in acute myocardial infarct patients following either intravenous thrombolysis or placebo. Symptom-limited bicycle ergometer tests, carried out one to two weeks from the infarction, were performed in 85 patients randomized to intravenous streptokinase (n = 41) or placebo (n = 44) given within 12 hours from onset of symptoms. Resting heart rate, systolic blood pressure and rate-pressure product were similar in the two groups. At maximum workload the streptokinase treated patients had a significantly higher median maximal heart rate than controls (136 vs. 126 min-1; p < 0.01) but only a trend towards higher systolic blood pressure was seen (175 vs. 163 mmHg; p = 0.09). Rate-pressure product at maximal exercise was 23.620 vs. 20.100 mmHg x min-1; p < 0.01). A significantly smaller number of patients in the streptokinase group had exercise capacity below 50 W (0% vs. 15.9%; p < 0.01).
patients treated with intravenous streptokinase for acute myocardial infarction reach both higher heart rates and rate-pressure products at maximum workload than their controls thus indicating that the beneficial effects of thrombolysis after acute myocardial infarction are reflected in an improved heart rate response during exercise.
运动试验变量，如心率反应受损，已知与急性心肌梗死后的左心室功能和患者预后相关。本研究旨在比较急性心肌梗死患者接受静脉溶栓或安慰剂治疗后的运动试验变量。对85例患者进行了症状受限的自行车测力计测试，这些患者在症状发作后12小时内随机接受静脉链激酶（n = 41）或安慰剂（n = 44）治疗，并在心肌梗死后1至2周进行测试。两组的静息心率、收缩压和心率血压乘积相似。在最大负荷时，链激酶治疗的患者的最大心率中位数显著高于对照组（136对126次/分钟；p < 0.01），但仅观察到收缩压有升高趋势（175对163 mmHg；p = 0.09）。最大运动时的心率血压乘积为23620对20100 mmHg·min-1；p < 0.01）。链激酶组中运动能力低于50 W的患者数量显著较少（0%对15.9%；p < 0.01）。
急性心肌梗死患者接受静脉链激酶治疗后，在最大负荷时达到的心率和心率血压乘积均高于对照组，这表明急性心肌梗死后溶栓的有益效果体现在运动期间心率反应的改善上。
