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題 名 | Different Exercise Performance between Aged Patients with Syndrome X and Those with Coronary Artery Disease=老年X症候群病患及冠狀動脈疾病病患之運動心電圖比較 |
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作 者 | 徐迺維; 陳肇文; 任勗龍; 馬光遠; 李文領; 王石補; 張茂松; | 書刊名 | 中華醫學雜誌 |
卷 期 | 58:4 1996.10[民85.10] |
頁 次 | 頁241-247 |
分類號 | 415.3023 |
關鍵詞 | 心肌缺氧; X症候群; 運動心電圖; Myocardial ischemia; Syndrome X; Treadmill exercise test; |
語 文 | 英文(English) |
中文摘要 | 背景 X症候群病患和冠狀動脈疾病病患一樣,也會在運動時,於心 電圖上出現缺氧的現象。但相對於冠狀動脈疾病病患是因為阻塞性血管病灶引 起血流供應不足而導致缺氧,X症候群病患造成運動心電圖的變化之機轉至今 仍不明。因此,二者在運動心電圖所表現出來的缺氧型態亦可能不同。 方法 本研究是藉由分析及比較X症候群病患及冠狀動脈疾病病患的運動心電 圖之各項參數,希望能分辨出兩者之異同,並進而推求X症候群病患可能的致 病機轉。 結果 本研究包括29位X症候群病患(27男2女,平均年齡64 +/- 6歲)及46 位冠狀動脈疾病病患(45男1女,平均年齡65 +/- 5歲)。結果顯示,X症候群病 患的心率(次/分鐘)在ST節下降1毫米(140 +/- 21 vs 123 +/- 2l, p < 0.001)及最高量 運動時(153 +/- 22 vs 130 +/- 21, p < 0.001)均明顯高於冠狀動脈疾病病患;其收縮 壓(毫米汞柱)在ST節下降1毫米(161 +/- 26 vs 150 +/- 21, p = 0.04)及最高量運動 時(174 +/- 23 vs 157 +/- 24, p < 0.001),心率壓力乘積(次x毫米汞柱/分鐘)在ST節 下降1毫米(22795 +/- 5459 vs 18346 +/- 4146, p < 0.001)及最高量運動時(26755 +/- 5245 vs 20304 +/- 4351, p < 0.001)亦高於冠狀動脈疾病病患。而至ST節下降1毫 米所需時間(秒) (304 +/- 128 vs 254 +/- 92, p = 0.06)及全部運動時間(秒) (463 +/- 108 vs 331 +/- 111, p < 0.00l),X症候群病患亦較長。 結論 本研究顯示X症候群病患有較高的缺氧閥值及較好的運動表現。而由其 在不同負荷期皆表現出較高之心率、收縮壓,及心率壓力乘積觀之,較高的新 陳代謝需求(可能是由於交感神經過度活動)或許是造成年老的X症候群病患運 動時缺氧的原因之一。 |
英文摘要 | Background. Both patients with coronary artery disease (CAD) and those with syndrome X (anginal chest pain, exercise-induced myocardial ischemia, normal coronary angiogram and no evidence of coronary spasm) have ischemic electrocardiogram (ECG) during exercise. However, the difference of ECG change during treadmill exercise test in these two patient groups has rarely been studied. Methods. In this prospective study, we evaluated and compared the changes of hemodynamics and 12-lead ECG during treadmill exercise test by modified Bruce protocol in 29 patients with syndrome X and 46 patients with CAD. Results. As compared with CAD patients, syndrome X patients had significantly higher heart rate, higher systolic blood pressure and higher rate-pressure product at l mm ST depression and peak exercise. The time to l mm ST depression (304 +/- 128 vs 254 +/- 92 seconds, p = 0.06) and total exercise duration (463 +/- 108 vs 331 +/- 111 seconds, p < 0.001) were also longer in syndrome X than in CAD patients. However, coronary flow reserves, obtained from 20 syndrome X patients and 9 CAD patients, did not differ between both groups. (2.3 +/- 0.6 vs 2.5 +/- 0.6, p = NS) Conclusions. Patients with syndrome X had higher ischemic threshold and better exercise tolerance than CAD patients though coronary flow reserve was similar between them. During exercise, more work-load as well as metabolic demands was required for the development of similar degree of myocardial ischemia in these aged syndrome X patients as compared with CAD patients. |
本系統中英文摘要資訊取自各篇刊載內容。