高血压伴胸痛患者运动耐量相关因素分析

目的探讨高血压伴胸痛患者平板运动试验运动耐量的影响因素。方法纳入因胸痛行平板运动试验检查的高血压患者136例,进行症状限制性平板运动试验,将所达到的运动耐量与按年龄预测的最大运动耐量进行比较,分为两组:Ⅰ组(实际运动耐量≥预测运动耐量)、Ⅱ组(实际运动耐量预测运动耐量);比较两组患者年龄、性别、体质指数(BMI)、血脂、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)等指标,采用多元线性回归分析影响运动耐量的影响因素。结果Ⅱ组患者静息心率、BMI、FINS、HOMA-IR显著高于Ⅰ组患者,分别为(78.3±5.4)次/min vs.(72.1±6.0)次/min,P0.001],(26.4±2.8)kg/m2 vs.(24.1±2.6)kg/m2,P0.001],(12.9±4.8)μIU/ml vs.(8.6±2.6)μIU/ml,P0.001],(3.82±1.66)vs.(2.21±1.23),P0.001]。多元线性逐步回归分析显示,性别(女性)、年龄、静息心率、胰岛素抵抗指数与运动耐量呈负相关(标准回归系数β分别为:-0.547,-0.396,-0.336,-0.438;P均0.05)。结论高血压伴胸痛患者女性、年龄增长、静息心率增快及胰岛素抵抗指数增加是其运动耐量减低的重要影响因素。

Factors related to exercise capacity in patients with hypertension accompanied by chest pain

Objective To discuss the influence factors related to exercise capacity in patients with hypertension accompanied by chest pain during treadmill exercise test. Methods The patients （n=136） with hypertension accompanied by chest pain were chosen and given symptom-limited treadmill exercise test. All patients were divided into group I （achieved exercise capacity≥predicted exercise capacity） and group II （achieved exercise capacity〈predicted exercise capacity）. The indexes of age, sex, body mass index （BMI）, blood fat, fasting plasma glucose （FPG）, fasting insulin （FINS） and homeostasis model assessment of insulin resistance （HOMA-IR） were compared between 2 groups. The influence factors related to exercise capacity were analyzed by using multiple linear regression analysis （MLR）. Results In group II, resting heart rate （RHR）, BMI, FINS and HOMA-IR were significantly higher than those in group I （78.3±5.4） time/min vs. （72.1±6.0） time/min, P＆lt;0.001], （26.4 ±2.8） kg/m^2 vs. （24.1±2.6） kg/m2, P〈0.001], （12.9±4.8）μIU/ml vs. （8.6±2.6）μIU/ml, P〈0.001] and （3.82±1.66） vs. （2.21±1.23）, P〈0.001]. MLR showed that sex （female）, age, RHR, HOMA-IR were negatively correlated to exercise capacity （standard regression coefficientβwas, respectively,-0.547,-0.396,-0.336 and-0.438, all P〈0.05）. Conclusion In the patients with hypertension accompanied by chest pain, female, aging, RHR increasing and higher HOMA-IR are influence factors reducing exercise capacity.