冠状动脉临界病变患者心肺能力与运动后心率恢复的相关性

doi:10.3969/j.issn.1006-9771.2025.07.011

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (7): 838-845.doi: 10.3969/j.issn.1006-9771.2025.07.011

冠状动脉临界病变患者心肺能力与运动后心率恢复的相关性

唐丽¹^,², 戈晓珍¹^,², 刘杰¹^,², 张焱¹^,², 王金荣¹^,², 左雪冰¹^,², 王国栋¹^,²()

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院心血管内科，北京市 100068

收稿日期:2025-02-24 修回日期:2025-06-01 出版日期:2025-07-25 发布日期:2025-07-30
通讯作者: 王国栋(1972-)，男，汉族，山东诸城市人，博士，主任医师，主要研究方向：冠心病介入诊治、心血管危重症抢救及心脏康复。，E-mail： wangguodong@ccmu.edu.cn
作者简介:唐丽(1990-)，女，汉族，湖南邵东市人，硕士，主治医师，主要研究方向：心脏病康复。
基金资助:
中国康复研究中心科研课题(2023zx-22)

Correlation between cardiopulmonary capacity and heart rate recovery after exercise in patients with coronary borderline lesions

TANG Li¹^,², GE Xiaozhen¹^,², LIU Jie¹^,², ZHANG Yan¹^,², WANG Jingrong¹^,², ZUO Xuebing¹^,², WANG Guodong¹^,²()

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2. Department of Cardiology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2025-02-24 Revised:2025-06-01 Published:2025-07-25 Online:2025-07-30
Contact: WANG Guodong, E-mail: wangguodong@ccmu.edu.cn
Supported by:
China Rehabilitation Research Center Scientific Research Fund(2023zx-22)

摘要/Abstract

摘要：

目的探讨冠状动脉临界病变患者心肺运动试验中峰值摄氧量(VO₂peak)与运动后心率恢复(HRR)的特点及两者的相关性。

方法 2022年1月至2024年1月，北京博爱医院183例冠状动脉临界病变患者，根据VO₂peak分为低心肺能力(LCF)组(n = 61)、中等心肺能力(MCF)组(n = 62)和高心肺能力(HCF)组(n = 60)。比较各组间的临床资料、心肺运动试验数据(VO₂peak、HR1、HR2、HR3、HRR1、HRR2和HRR3)，分析VO₂peak与HRR的相关性。

结果协方差分析显示，校正年龄与体质量指数后，LCF组峰值心率、HR1、HR2和HR3最低(F > 5.388, P < 0.01)。重复测量方差分析显示，HRR的组间和时间效应均显著(F > 14.561, P < 0.001)。偏相关分析表明，VO₂peak与HRR1 (r = 0.404, P < 0.001)、HRR2 (r = 0.379, P < 0.001)和HRR3 (r = 0.425, P < 0.001)均呈显著正相关。

结论在冠状动脉临界病变患者中，VO₂peak水平越低，HRR延迟现象越明显。

关键词: 冠状动脉临界病变, 心率恢复, 峰值摄氧量, 心肺运动试验, 心肺能力

Abstract:

Objective To investigate the characteristics and correlation between peak oxygen uptake (VO₂peak) and heart rate recovery (HRR) during cardiopulmonary exercise test (CPET) in patients with coronary borderline lesions.

Methods From January, 2022 to January, 2024, 183 patients with coronary borderline lesions in Beijing Bo'ai Hospital were divided into low cardiorespiratory fitness (LCF) group (n = 61), moderate cardiorespiratory fitness (MCF) group (n = 62) and high cardiorespiratory fitness (HCF) group (n = 60) based on VO₂peak. Their characteristics and CPET parameters including VO₂peak, exercise-phase heart rate (HR1, HR2, HR3), and post-exercise heart rate recovery (HRR1, HRR2, HRR3) were analyzed.

Results After adjusting for age and body mass index, analysis of covariance showed that the peak heart rate, HR1, HR2 and HR3 were the lowest in LCF group (F > 5.388, P < 0.01). Repeated-measures analysis of variance showed that the inter- and intra-group effects were significant in HRR (F > 14.561, P < 0.001). Partial correlation analysis showed that VO₂peak positively correlated with HRR1 (r= 0.404, P< 0.001), HRR2 (r = 0.379, P < 0.001) and HRR3 (r= 0.425, P < 0.001).

Conclusion In patients with coronary artery borderline lesions, VO₂peak demonstrated a significant inverse correlation with HRR, the lower the VO₂peak, the more delays of HRR.

Key words: coronary borderline lesions, heart rate recovery, peak oxygen uptake, cardiopulmonary exercise test, cardiopulmonary capacity

中图分类号:

R541.4

唐丽, 戈晓珍, 刘杰, 张焱, 王金荣, 左雪冰, 王国栋. 冠状动脉临界病变患者心肺能力与运动后心率恢复的相关性[J]. 《中国康复理论与实践》, 2025, 31(7): 838-845.

TANG Li, GE Xiaozhen, LIU Jie, ZHANG Yan, WANG Jingrong, ZUO Xuebing, WANG Guodong. Correlation between cardiopulmonary capacity and heart rate recovery after exercise in patients with coronary borderline lesions[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(7): 838-845.

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项目	LCF组(n = 61)	MCF(n = 62)	HCF(n = 60)	χ²/F/Z值	P值
年龄/岁	64.21±6.88	61.50±7.34	60.38±6.00	5.140	0.007
体质量指数/(kg·m^-2)	26.14±3.11	26.17±2.73	24.84±2.81	4.232	0.016
性别(男/女)/n	32/29	36/26	40/20	2.560	0.278
β受体阻滞剂(未服用/服用)/n	32/29	34/28	31/29	0.134	0.935
高血压病史(无/有)/n	22/39	16/46	22/38	2.085	0.354
2型糖尿病病史(无/有)/n	43/18	44/18	45/15	0.371	0.832
高脂血症病史(无/有)/n	15/46	18/44	20/40	1.129	0.570
吸烟史(无/有)/n	33/28	35/27	29/31	0.853	0.654
饮酒史(无/有)/n	42/19	47/15	40/20	1.343	0.511
左室射血分数/%	64.10±9.22	65.65±7.54	66.30±5.45	1.351	0.261
左室舒张末径/mm	46.90±7.15	47.29±5.31	45.67±3.97	1.371	0.256
血红蛋白/(g·L^-1)	141.79±14.34	142.84±14.55	143.25±12.82	0.180	0.837
肌酐/(μmol·L^-1)	67.00 (57.50,80.40)	68.70 (59.70,76.70)	70.20 (62.53,76.65)	0.957	0.623
总胆固醇/(mmol·L^-1)	4.21 (3.61,5.24)	4.21 (3.71,4.89)	4.19 (3.42,5.00)	0.713	0.700
甘油三酯/(mmol·L^-1)	1.40 (1.06,1.96)	1.36 (1.02,1.97)	1.20 (0.82,1.78)	5.371	0.068
低密度脂蛋白/(mmol·L^-1)	2.51 (2.03,3.37)	2.37 (1.92,2.92)	2.58 (2.00,3.25)	1.120	0.570
高密度脂蛋白/(mmol·L^-1)	1.14 (1.03,1.31)	1.19 (0.98,1.38)	1.15 (1.00,1.37)	0.291	0.864
糖化血红蛋白/%	6.10 (5.80,7.10)	6.00 (5.60,6.79)	6.01 (5.62,6.40)	2.250	0.325
血沉/(mm·h^-1)	13.02 (8.00,13.02)	13.02 (8.00,13.02)	11.50 (6.75,13.02)	2.493	0.289

项目	LCF组(n = 61)	MCF(n = 62)	HCF(n = 60)	F/Z值	P值
静息心率/(次·min^-1)	69.69±9.67	68.00±8.45	67.50±7.32	1.095	0.337
峰值心率/(次·min^-1)	109.43±13.49	117.77±13.35	128.87±15.12	29.230	< 0.001
HR1/(次·min^-1)	86.52±12.0	89.84±12.42	95.25±11.89	7.993	< 0.001
HR2/(次·min^-1)	80.57±11.30	83.82±11.58	89.60±11.25	9.749	< 0.001
HR3/(次·min^-1)	78.05±10.64	80.90±10.87	85.51±10.01	7.752	0.001
HRR1/(次·min^-1)	22.90±9.23	27.94±9.37	33.62±8.72	20.910	< 0.001
HRR2/(次·min^-1)	28.85±10.07	33.95±9.01	39.27±10.25	17.130	< 0.001
HRR3/(次·min^-1)	31.38±9.72	36.87±9.99	43.35±10.59	21.280	< 0.001
静息摄氧量/(mL·min^-1)	268.00 (215.00,314.00)	292.00 (248.25,341.75)	294.00 (238.75,352.50)	5.590	0.061
静息收缩压/mmHg	123.00 (114.00,132.00)	119.00 (109.00,132.00)	123.00 (113.00,137.00)	2.040	0.361

组别	n	静息心率/ (次·min^-1)	无氧阈时心率/(次·min^-1)	峰值心率/ (次·min^-1)	HR1/(次·min^-1)	HR2/(次·min^-1)	HR3/(次·min^-1)
LCF组	61	69.67±9.67	93.03±8.42^a	109.43±13.49^a	86.83±12.00^a	80.57±11.31^a	78.05±10.65^a
MCF组	62	68.00±7.45	92.92±21.37^a	117.77±13.35^b	89.84±12.42^a	83.82±11.58^a	80.90±10.87^a
HCF组	60	67.50±7.32	103.68±14.07^b	128.87±15.19^c	92.25±11.89^b	89.6±11.25^b	85.52±10.01^b
F值		2.770	6.876	20.345	5.568	7.547	5.388
P值		0.065	0.001	< 0.001	0.005	< 0.001	0.005

组别	n	HRR1		HRR2		HRR3
组别	n	均数	标准差	均数	标准差	均数	标准差
LCF组	61	22.90	9.23	28.85	10.07	31.38	9.72
MCF组	62	27.94	9.37	33.95	9.01	36.87	9.98
HCF组	60	33.62	8.72	39.37	10.25	43.35	10.59

项目	平方和	自由度	均方	F值	P值
组别	2182.0	2	1091.0	14.561	< 0.001
时间	6482.0	2	3241.0	43.257	< 0.001
组别×时间	554.4	4	138.6	1.850	0.118

冠状动脉临界病变患者心肺能力与运动后心率恢复的相关性

Correlation between cardiopulmonary capacity and heart rate recovery after exercise in patients with coronary borderline lesions

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