Mitsumune T, Matsuo K, Funaki K, Morikawa A, Takamura K, Aoi T, Senoh E, Kayashima E, Hara Y
Junpukai Health Maintenance Center, Okayama, Japan.
Sangyo Eiseigaku Zasshi. 1997 Sep;39(5):186-90.
We conducted ergometer exercise electrocardiography (ergometry) on 3,477 subjects in a THP (Total Health Promotion Plan). One hundred cases in which abnormal findings were detected by ergometry were analyzed. In the hundred cases there were 3 patterns: abnormal ST change, 50 cases; abnormal reaction, 22 cases; and extreme increase in blood pressure, 28 cases. Electrocardiograms (ECG) in 78 of these 100 cases indicated no abnormalities. Of the 31 subjects who underwent further examinations, in 18 cases abnormal findings were detected, and further observation or treatment was necessary. They were over two thirds of the 26 cases requiring observation or treatment on further examination. In other words, exercise electrocardiography revealed more than 3 times as many problem cases as electrocardiography only. One hundred and four cases were analyzed, and among them abnormal findings on ECG made further examination or treatment necessary. Of 68 subjects with an abnormal ECG and who needed to undergo exercise electrocardiography, 51 (75%) had no need to undergo further examinations, because there were no abnormal findings on ergometry in the THP. Of the 104 subjects who underwent ECG examination at rest, 51 no longer needed to waste time, effort and expense on further medical evaluation. Ergometry in a THP serves as a medical check and as a means to decide the strength of exercise before the initiation of exercise training, which is very important in preventing coronary artery disease, rather than in detecting the disease. Ergometry is expensive and it takes a lot of time and labor, but it is necessary in ensuring the safety of exercise training and in prescribing proper exercise. This analysis has shown that ergometry in THP is very useful and cost effective in improving the accuracy of health examinations.
我们对一项全面健康促进计划（THP）中的3477名受试者进行了测力计运动心电图检查（踏车运动试验）。对其中通过踏车运动试验检测出异常结果的100例病例进行了分析。在这100例病例中存在3种模式：ST段异常改变，50例；异常反应，22例；血压极度升高，28例。这100例病例中的78例心电图（ECG）显示无异常。在接受进一步检查的31名受试者中，有18例检测出异常结果，需要进一步观察或治疗。他们占进一步检查后需要观察或治疗的26例病例的三分之二以上。换句话说，运动心电图检查发现的问题病例是仅做心电图检查的3倍多。对104例病例进行了分析，其中ECG异常结果使得有必要进行进一步检查或治疗。在68例ECG异常且需要进行运动心电图检查的受试者中，有51例（75%）无需进一步检查，因为在THP中踏车运动试验未发现异常结果。在104例接受静息ECG检查的受试者中，有51例无需再在进一步医学评估上浪费时间、精力和费用。THP中的踏车运动试验可作为一种医学检查，也是在开始运动训练前确定运动强度的一种手段，这对于预防冠状动脉疾病非常重要，而非用于检测该疾病。踏车运动试验费用高昂，且耗费大量时间和人力，但对于确保运动训练的安全性和制定适当的运动方案是必要的。该分析表明，THP中的踏车运动试验在提高健康检查准确性方面非常有用且具有成本效益。
