本文關(guān)鍵詞： 高血壓 心肺運(yùn)動(dòng)試驗(yàn) 個(gè)體化適度強(qiáng)度運(yùn)動(dòng) 整體治療方案 有效治療 連續(xù)無創(chuàng)逐搏血壓 心肺運(yùn)動(dòng)試驗(yàn) 運(yùn)動(dòng)試驗(yàn)停止指征　出處：《北京協(xié)和醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:運(yùn)用心肺運(yùn)動(dòng)試驗(yàn)(cardiopulmonary exercise testing,CPET)對(duì)患者進(jìn)行客觀定量整體功能評(píng)估,精準(zhǔn)制定個(gè)體化適度強(qiáng)度運(yùn)動(dòng)整體治療方案,以有效治療高血壓。方法:選擇5例應(yīng)用藥物治療穩(wěn)定的高血壓患者進(jìn)行癥狀限制性CPET檢查,以CPET結(jié)果為依據(jù)進(jìn)行計(jì)算分析,進(jìn)而精準(zhǔn)地制定介于無氧閡和峰值功率之間的個(gè)體化適度強(qiáng)度負(fù)荷功率的運(yùn)動(dòng)處方,配合多種輔助運(yùn)動(dòng)、精神心理方面、勞逸結(jié)合、睡眠管理、禁煙限酒、健康飲食生活習(xí)慣及優(yōu)化藥物等形成整體方案。堅(jiān)持每天強(qiáng)化運(yùn)動(dòng)一次、每周5天,共計(jì)12周,每天測定患者運(yùn)動(dòng)前、后的血壓,運(yùn)動(dòng)中連續(xù)監(jiān)測血壓、心電圖、心率和氧飽和度,期間根據(jù)血壓穩(wěn)定程度調(diào)整藥物。將運(yùn)動(dòng)前、后和第1、12周血壓的變化進(jìn)行自身對(duì)照統(tǒng)計(jì)分析。結(jié)果:高血壓患者運(yùn)動(dòng)治療前均服用至少一種降壓藥物,運(yùn)動(dòng)治療2～6周后全部停用降壓藥物。患者運(yùn)動(dòng)后收縮壓(systolicblood pressure,SBP)[運(yùn)動(dòng)前(125±11)mmHg與運(yùn)動(dòng)后(116±10)mm Hg]、舒張壓(diastolic blood pressure,DBP)[運(yùn)動(dòng)前(74±8)mm Hg與運(yùn)動(dòng)后(71±7)mmHg]均較運(yùn)動(dòng)前顯著降低(P0.05)。雖然第12周時(shí)已經(jīng)減、停用抗高血壓藥物6周以上,運(yùn)動(dòng)前靜息SBP仍較第1周(使用藥物時(shí))顯著降低[第1周(127±8)m Hg與第12周(121±9)m Hg](P0.05);第1周與第12周運(yùn)動(dòng)后靜息SBP、運(yùn)動(dòng)前后靜息DBP比較均無統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:本研究運(yùn)用CPET客觀定量評(píng)估指導(dǎo)的精準(zhǔn)制訂個(gè)體化適度強(qiáng)度運(yùn)動(dòng)為核心的整體方案,可以使高血壓病患者獲得驚人的降壓效果,并且停藥后仍然能夠維持血壓穩(wěn)定。值得進(jìn)一步擴(kuò)大病例深入研究。目的:通過無創(chuàng)方法監(jiān)測心肺運(yùn)動(dòng)試驗(yàn)(cardiopulmonary exercise testing,CPET)過程中的逐搏血壓,同時(shí)與傳統(tǒng)的袖帶間斷測壓相比較,重點(diǎn)觀察心肺運(yùn)動(dòng)試驗(yàn)過程中的最高血壓值,以探討定量的血壓值是否能夠作為終止心肺運(yùn)動(dòng)試驗(yàn)指征。方法:選擇2016年8-10月份在阜外醫(yī)院進(jìn)行CPET的健康志愿者6例,在常規(guī)的心肺運(yùn)動(dòng)試驗(yàn)中佩戴連續(xù)無創(chuàng)逐搏血壓監(jiān)測儀器。對(duì)不同階段的袖帶間斷測壓與連續(xù)逐搏血壓值進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:在心肺運(yùn)動(dòng)試驗(yàn)過程中6位志愿者中有兩位的最高血壓超過了 250mmHg,而袖帶間斷測壓檢測到的最高血壓僅為187mmHg。收縮壓在熱身期以及恢復(fù)期5分鐘有統(tǒng)計(jì)學(xué)差異(p0.05),其他時(shí)期無統(tǒng)計(jì)學(xué)差異;舒張壓在恢復(fù)期2分鐘及恢復(fù)期5分鐘有統(tǒng)計(jì)學(xué)差異(pp0.05),其他時(shí)期無統(tǒng)計(jì)學(xué)差異。結(jié)論:連續(xù)逐搏血壓可更好的反映CPET中的血壓連續(xù)狀態(tài)以及極限值。在癥狀限制性的CPET中,并不能完全以某一特定的最高血壓值作為參考作為終止心肺運(yùn)動(dòng)試驗(yàn)的指標(biāo)。
[Abstract]:Objective: to evaluate the overall function of patients with cardiopulmonary exercise test by using cardiopulmonary exercise test (CPET), and to formulate the individual moderate intensity exercise therapy accurately. Methods: five patients with stable hypertension who were treated with drugs were selected for symptomatic restricted CPET examination. The results of CPET were calculated and analyzed. And then make the exercise prescription of the individualized moderate intensity load power between the anaerobic barrier and the peak power accurately, and cooperate with various auxiliary sports, mental and psychological aspects, the combination of labor and rest, sleep management, no smoking and limiting alcohol, Health eating habits and optimizing medicine were the overall plan. The patients' blood pressure before and after exercise, monitoring blood pressure and electrocardiogram (ECG) were measured every day, 5 days a week, 5 days a week for a total of 12 weeks, the patients' blood pressure was measured before and after exercise, and the blood pressure and electrocardiogram were continuously monitored during exercise. Heart rate and oxygen saturation were adjusted according to the degree of blood pressure stability. The changes of blood pressure before, after and at 1th week were compared and analyzed. Results: patients with hypertension took at least one antihypertensive drug before exercise treatment. Systolic blood pressure pressure (SBP) [125 鹵11mm Hg before exercise and 116 鹵10mm Hg after exercise], diastolic blood pressure pressure (DBP) [74 鹵8mm Hg before exercise and 71 鹵7mm Hg after exercise] were significantly lower than those before exercise (125 鹵11mm Hg and 116 鹵10mm Hg after exercise) [74 鹵8mm Hg before exercise and 71 鹵7mm Hg after exercise]. Stop antihypertensive drugs for more than 6 weeks. Resting SBP before exercise was still significantly lower than that at week 1 (drug use) [1 week (127 鹵8 mm Hg) and 12 week (121 鹵9 mm Hg)] P 0.05A, and after 1 week and 12 weeks of exercise, there was no significant difference in resting DBP before and after exercise (P 0.05). Conclusion: this study shows that there is no significant difference in resting DBP before and after exercise. Conclusion: this study shows that there is no significant difference between the rest DBP before and after exercise. Conclusion: this study shows that there is no significant difference between the rest DBP before and after exercise. Using CPET objective quantitative evaluation to guide the accurate formulation of individual moderate intensity exercise as the core of the overall plan, Can make the hypertension patient obtain the astonishing effect of lowering blood pressure, And it can still maintain blood pressure stability after withdrawal, which is worthy of further study. Objective: to monitor the stroke blood pressure during cardiopulmonary exercise testing in cardiopulmonary exercise test (cardiopulmonary exercise testing) by non-invasive method, and to compare it with the traditional cuff intermittent blood pressure measurement. The maximum blood pressure during cardiopulmonary exercise test was observed in order to find out whether the quantitative blood pressure could be used as the indication of termination of cardiopulmonary exercise test. Methods: six healthy volunteers who underwent CPET in Fuwei Hospital from 2016 to October were selected. In the routine cardiopulmonary exercise test, a continuous noninvasive blood pressure monitoring instrument was worn. The values of intermittent cuff blood pressure and continuous stroke blood pressure in different stages were analyzed statistically. Results: during the cardiopulmonary exercise test, 6 records were performed. Two of the patients had the highest hypertension over 250 mmHg, while the most hypertension detected by cuff intermittent manometry was 187mm Hg.There was a significant difference in systolic blood pressure between warm up period and 5 minute recovery period (p 0.05), but there was no statistical difference in other periods. Diastolic blood pressure (DBP) was significantly different in 2 minutes of recovery period and 5 minutes of recovery period, but there was no statistical difference in other periods. Conclusion: continuous stroke blood pressure can better reflect the continuous state and limit value of blood pressure in CPET. No specific maximum blood pressure can be used as a reference for termination of cardiopulmonary exercise test.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R544.1

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 郝湛軍,張延斌;運(yùn)動(dòng)試驗(yàn)對(duì)心尖肥厚型心肌病患者心電圖的影響[J];徐州醫(yī)學(xué)院學(xué)報(bào);2000年06期

2 王林生,劉湘香,劉愛兵,曹偉民,劉國亭,王慶元;招飛青年運(yùn)動(dòng)試驗(yàn)后血尿和蛋白尿動(dòng)態(tài)觀察[J];中華航空航天醫(yī)學(xué)雜志;2001年04期

3 高怡;鐘麗萍;謝慧玲;李曉塵;鄭勁平;;慢性阻塞性肺疾病患者心肺運(yùn)動(dòng)試驗(yàn)安全性分析[J];中國實(shí)用內(nèi)科雜志;2013年S1期

4 杜辛;聶采現(xiàn);晏俊儒;劉書琴;;下蹲運(yùn)動(dòng)試驗(yàn)與雙倍二級(jí)梯運(yùn)動(dòng)試驗(yàn)的對(duì)比觀察[J];四川醫(yī)學(xué);1980年02期

5 向培斌;;運(yùn)動(dòng)試驗(yàn)的并發(fā)癥:三個(gè)德語國家的調(diào)查[J];國外醫(yī)學(xué).心血管疾病分冊(cè);1983年02期

6 Dean E;夏芩春;;提高臨床運(yùn)動(dòng)試驗(yàn)的正確性:練習(xí)與實(shí)施的關(guān)系[J];國外醫(yī)學(xué)(物理醫(yī)學(xué)與康復(fù)學(xué)分冊(cè));1991年01期

7 張長城,孫宇;運(yùn)動(dòng)試驗(yàn)的應(yīng)用進(jìn)展[J];心臟雜志;2001年02期

8 郭穎;小兒運(yùn)動(dòng)試驗(yàn)的生理變化及臨床應(yīng)用[J];臨床兒科雜志;2002年09期

9 吳翔明;運(yùn)動(dòng)試驗(yàn)心電圖T波正�；颊�15年隨訪[J];實(shí)用心電學(xué)雜志;2003年02期

10 岳宏麗,鄒俊麗;運(yùn)動(dòng)試驗(yàn)致心率一過性減慢1例[J];實(shí)用心電學(xué)雜志;2003年06期

相關(guān)會(huì)議論文 前10條

1 陳定光;鄭漢林;駱桂珍;伏廣清;;次極量運(yùn)動(dòng)試驗(yàn)在飛行員健康鑒定中的價(jià)值——附9例異常結(jié)果的分析[A];第四屆全國心功能學(xué)術(shù)研討會(huì)論文摘要集[C];1994年

2 李翠蘭;胡大一;史旭波;楊虎;王吉云;劉杰;劉文玲;李蕾;許玉韻;;長QT綜合征患者運(yùn)動(dòng)試驗(yàn)特征及左心交感神經(jīng)切除術(shù)的影響[A];中華醫(yī)學(xué)會(huì)心血管病分會(huì)第八次全國心血管病學(xué)術(shù)會(huì)議匯編[C];2004年

3 車琳;王樂民;;心肺運(yùn)動(dòng)試驗(yàn)的臨床應(yīng)用[A];中國康復(fù)醫(yī)學(xué)會(huì)第七次全國老年醫(yī)學(xué)與康復(fù)學(xué)術(shù)大會(huì)資料匯編[C];2012年

4 楊杰;;運(yùn)動(dòng)試驗(yàn)誘發(fā)血管迷走暈厥1例報(bào)道[A];2004年浙江省心血管病學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2004年

5 馬劍英;錢菊英;葛均波;;心肌橋患者運(yùn)動(dòng)試驗(yàn)的特點(diǎn)[A];第十三次全國心血管病學(xué)術(shù)會(huì)議論文集[C];2011年

6 馬劍英;錢菊英;董敏;樊冰;王奇冰;葛雷;劉學(xué)波;張峰;葛均波;;心肌橋患者運(yùn)動(dòng)試驗(yàn)陽性的特點(diǎn)[A];中華醫(yī)學(xué)會(huì)第11次心血管病學(xué)術(shù)會(huì)議論文摘要集[C];2009年

7 姚亞嵐;朱永耕;王俊文;;運(yùn)動(dòng)試驗(yàn)ΔR，，ΔRST，ΔQ，∈R指標(biāo)的臨床研究[A];第二屆全國心功能學(xué)術(shù)研討會(huì)論文摘要匯編[C];1990年

8 劉銘;方力爭;;心肺運(yùn)動(dòng)試驗(yàn)的臨床應(yīng)用[A];浙江省醫(yī)學(xué)會(huì)健康管理學(xué)分會(huì)第二屆學(xué)術(shù)年會(huì)論文集[C];2009年

9 滕化民;柯玲;;限制性陽性運(yùn)動(dòng)試驗(yàn)中患者的癥狀特點(diǎn)[A];中華醫(yī)學(xué)會(huì)心血管病學(xué)分會(huì)第八次全國心血管病學(xué)術(shù)會(huì)議匯編[C];2006年

10 趙晶;;夾層動(dòng)脈瘤術(shù)前血壓控制的護(hù)理體會(huì)[A];全國內(nèi)科護(hù)理學(xué)術(shù)交流暨專題講座會(huì)議論文匯編[C];2004年

相關(guān)重要報(bào)紙文章 前10條

1 健康時(shí)報(bào)特約記者 孟慶玲;運(yùn)動(dòng)前做心肺試驗(yàn)[N];健康時(shí)報(bào);2009年

2 復(fù)旦大學(xué)附屬中山醫(yī)院 上海市心血管病研究所 主治醫(yī)師 程蕾蕾;什么叫做運(yùn)動(dòng)試驗(yàn)[N];家庭醫(yī)生報(bào);2003年

3 北京大學(xué)人民醫(yī)院心內(nèi)科主任醫(yī)師 胡大一;有氧運(yùn)動(dòng)利降壓[N];保健時(shí)報(bào);2008年

4 健康時(shí)報(bào)特約記者 孟慶玲;退休后先查查心肺功能[N];健康時(shí)報(bào);2009年

5 李瑞星;冬天血壓應(yīng)勤量[N];保健時(shí)報(bào);2007年

6 白軼南;冬天多測幾次血壓[N];健康時(shí)報(bào);2007年

7 北京軍區(qū)總醫(yī)院心肺血管中心主任醫(yī)師 和渝斌;天氣涼了,血壓計(jì)別離身[N];健康時(shí)報(bào);2008年

8 保健時(shí)報(bào)記者 范宏博;三大要點(diǎn)穩(wěn)血壓[N];保健時(shí)報(bào);2010年

9 河南省人民醫(yī)院心內(nèi)科主任醫(yī)師 孫琳;在家測血壓 條條框框多[N];健康報(bào);2013年

10 韓詠霞;天冷血壓易增高[N];農(nóng)村醫(yī)藥報(bào)（漢）;2006年

相關(guān)博士學(xué)位論文 前3條

1 唐毅;攝氧效率斜率預(yù)測特發(fā)性肺動(dòng)脈高壓預(yù)后[D];北京協(xié)和醫(yī)學(xué)院;2017年

2 奚群英;慢性血栓栓塞性肺動(dòng)脈高壓的病理生理機(jī)制研究及心肺運(yùn)動(dòng)試驗(yàn)的預(yù)測作用[D];北京協(xié)和醫(yī)學(xué)院;2015年

3 丁明;慢性呼吸功能不全術(shù)前評(píng)估及其機(jī)制的初探[D];復(fù)旦大學(xué);2003年

相關(guān)碩士學(xué)位論文 前10條

1 葛萬剛;個(gè)體化運(yùn)動(dòng)有效治療高血壓的研究及逐搏血壓監(jiān)測在臨床中的應(yīng)用[D];北京協(xié)和醫(yī)學(xué)院;2017年

2 杜康;采用心肺運(yùn)動(dòng)試驗(yàn)探討慢性阻塞性肺疾病與伴發(fā)抑郁癥之間的影響[D];安徽醫(yī)科大學(xué);2015年

3 沈續(xù)瑞;阻塞性睡眠呼吸暫停對(duì)心肺運(yùn)動(dòng)試驗(yàn)指標(biāo)的影響[D];蘇州大學(xué);2015年

4 任雅琦;射血分?jǐn)?shù)正常心衰患者的心肺運(yùn)動(dòng)試驗(yàn)研究[D];南京醫(yī)科大學(xué);2013年

5 肖強(qiáng);心肺運(yùn)動(dòng)試驗(yàn)對(duì)肺動(dòng)脈高壓患者通氣有效性的評(píng)價(jià)[D];蘇州大學(xué);2016年

6 陳志高;心肺運(yùn)動(dòng)試驗(yàn)在心力衰竭患者中的應(yīng)用[D];北京協(xié)和醫(yī)學(xué)院;2016年

7 黃珊珊;半定量運(yùn)動(dòng)試驗(yàn)與腎上腺素試驗(yàn)的比較[D];山東大學(xué);2008年

8 孔虹倩;云南傣族和景頗族高血壓患病、控制及自我管理現(xiàn)狀比較研究[D];昆明醫(yī)科大學(xué);2017年

9 何剛;我國中老年人的肥胖和高血壓流行現(xiàn)狀及其關(guān)聯(lián)性分析[D];蘭州大學(xué);2017年

10 李冰融;成年人蔬菜水果攝入與高血壓關(guān)系的研究[D];青島大學(xué);2017年

本文編號(hào)：1538804