摘要目的 探讨亚极量心肺运动负荷试验和心脏康复对介入治疗后急性心肌梗死(AMI)患者的影响.方法 经介入治疗的AMI患者94例分为康复组和对照组,实施了心肺运动负荷试验和3个月的心脏康复观察,其中康复组患者根据无氧代谢阈值运动处方,进行有氧康复训练;对照组患者不给予运动处方,按自行需要活动.3个月后比较两组患者的运动心肺功能的变化.结果 患者无氧代谢阈值心率远远小于传统负荷试验的最小运动强度标准;康复组3个月后心肺功能均有改善,无氧代谢阈值氧耗量[(10.5±2.9)ml·min-1·kg-1和(12.6±2.9)ml.min-1·kg-1],运动负荷能力[(33±20)J·s-1和(42±16)J·s-1]峰值氧耗量[(14±4]ml·min-1·kg-1和(20±4)ml.min-1.kg-1]及峰值运动负荷能力[(66±21)J·s-1和(89±14)J·s-1]均明显增加,对照组3个月后的无氧代谢阈值氧耗量和运动负荷能力增加不明显,但峰值氧耗量[(14±4)ml.min-1.kg-1和(19±4)ml.min-1·kg-1]和峰值运动负荷能力[(64±21)J·s-1和(80±14)J.s-1]增加.结论 经介入治疗的AMI患者早期行亚极量心肺运动负荷试验和心脏康复是安全的,能有效地提高患者的氧代谢水平和运动耐受力.

abstractsObjective To investigate the safety and effects of early submaximal cardiopulmonary exercise test(CPET) and cardiac rehabilitation for patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI).Methods 94 patients with AMI after PCI were randomly divided into 2 groups:exercise group undergoing anaerobic rehabilitation training based on anaerobic threshold(AT) exercise prescription for 3 months,and control group,conducting exercme according to the needs of the Datients themselves.Three months later,the exercise cardiopulmonary function was evaluated.Results In the first CPET 89 patients attained their anaerobic threshold(AT)and their heart rates were lower than their target heart rates following the exercise test.The oxygen consumption at the anaerobic threshold(VO2AT)3[(14±4)ml.min-1.kg-1,P=0.000].The LAT 3 months of the exercise group was(42±16)J.The earlv submaximal CPET and cardiac rehabilitation for patients with AMI after PCI are not only safe but also can improve their exercise capacity.