Bruce-Q运动方案在心肺运动试验中的临床研究

采用心肺运动试验评定心脏起搏和其他器质性心脏病患者的全身耐力和心力储备，综合Ｂｒｕｃｅ方案和Ｎａｕｇｈｔｏｎ方案，在Ｂｒｕｃｅ方案的基础上增加１ｍｐｈ平板速度、５％斜率的运动负荷做为第一级运动，其余各级按照Ｂｒｕｃｅ方案进行。对１４７人进行了最大症状限制性心肺运动试验。其中正常人４０人、ＶＶＩＲ起搏２６例、其他器质性心脏病患者４１例。结果：正常人运动时间１２ｍｉｎ左右，非起搏心脏病患者和心脏起搏患者的运动时间６ｍｉｎ左右。窦房结对运动的反应呈频率应变的方式，其心率与做功的关系为Ｙ＝７５＋０．４１Ｘ；体动式频率应变性起搏频率和做功的关系为Ｙ＝８３．３９＋０．１８Ｘ。此外根据本方案运动试验的结果可进行心功能分级：能完成本方案的四、三、二、一级运动的心功能分级分别为一、二、三、四级。结论：本方案适宜正常人、非起搏心脏病患者和起搏患者的心肺运动试验。

The Clinical Study of BruceQ Protocol in Cardiopulmonary Exercise Testing

The cardiopulmonary exercise testing protocol is the most important in evaluating exercise tolerance,studying cardiac function and researching rate responsive pacing.It is known that Bruce protocol is by far the classical protocol of treadmill exercise for diagnosis of myocardial ischemia.Because of its higher workload at exercise beginning and larger increase workload at each stage,it is not suitable for patients with cardiac pacing.For this reason,We modified Bruce protocol and set speed at 1 mph and the slope of 5% as first stage exercise.The other stage of this protocol was same as Bruce protocol.There were 147 persons performed symptomatic limited exercise testing under this protocol.The results showed that duration of exercise was about 12 minutes in healthy persons and 6 minutes in patients with cardiac pacing or heart failure.The regression analysis suggested that the equations of heart rate and workload were Y=75 0.41X in healthy subjects and Y=83.39 0.18X in patients with VVIR pacing.This protocol may be used to measure anaerobic threshold and Vo2max,classify cardiac function.If patient can complete the fourth stage exercise,his heart function is normal.If he only perform the first stage of exercise,he is ill with severe heart failure.