运动后心率恢复对慢性阻塞性肺疾病稳定期评估价值的研究

目的研究慢性阻塞性肺疾病(慢阻肺)稳定期患者运动后心率恢复(heart rate recovery,HRR)与其CAT评分、mMRC评分及急性加重风险的关系,进而探讨HRR对慢阻肺稳定期评估的价值。方法选取2018年9月~2020年3月安徽医科大学第一附属医院门诊及住院的60例慢阻肺稳定期患者。所有患者均完成CAT评分、mMRC评分、记录过去1年的急性加重次数,并行6min步行试验(6MWT),运动结束后,记录即时心率与休息1min后心率差值即为运动后1分钟心率恢复(heart rate recovery after 1 minute,HRR1)。分析HRR1与CAT评分、mMRC评分相关性及其与急性加重风险的关系,并比较慢阻肺稳定期ABCD各组间HRR1差异。结果慢阻肺稳定期患者HRR1与CAT评分、mMRC评分呈明显负相关,Pearson相关系数分别为0.611、0.549,且均有统计学意义(P<0.01);急性加重频繁组患者、急性加重非频繁组患者HRR1分别为14.38±7.02次/分、24.68±7.67次/分,两者平均差值为10.30次/分,差异具有统计学意义(P<0.05);慢阻肺稳定期ABCD各组HRR1有显著差异,且总体呈逐渐下降趋势。结论慢阻肺患者运动后心率恢复对慢阻肺病情的评估具有一定价值,有助于评估患者病情。

Usefulness of heart rate recovery after 6-min walking test to evaluate patients with stable COPD

Objective To study the relationship of heart rate recovery after exercise with CAT score,mMRC score and acute exacerbation risk in stable COPD patients,in order to investigate the evaluation value of HRR for stable COPD.Methods 60 stable COPD patients in the first affiliated hospital of Anhui Medical University were enrolled,all of whom completed the HRR1 after 6MWT.COPD assessment test(CAT)questionnaire and modified Medical Research Council(mMRC)dyspnea scores were completed and the times of acute exacerbation in a year was recorded.All of them received 6MWT,and then their heart rate instantly and 1minute after were recorded.The relationship of heart rate recovery after 1 minute with CAT score,mMRC score and acute exacerbation risk in stable COPD patients was analyzed,and the differences in HRR1 among different stable COPD groups were compared.Results HRR1 was negatively correlated with CAT score and mMRC score(r=0.611,0.549;P<0.01).The value of HRR1 was 14.38±7.02 and 24.68±7.67 respectively in the frequent acute exacerbation group and the non-frequent acute exacerbation group,and there was an average 10.30-point difference between the two groups(P<0.01).Furthermore,there were significant differences in HRR1 among different COPD groups.Conclusion HRR1 after 6MWT provides a reliable marker in assessing stable COPD.