课件：心梗后心脏康复治疗.ppt

* * * This prospective study evaluated the role of walking and vigorous exercise in 73,743 postmenopausal women. Increasing quintiles of energy expenditure were inversely associated with the risk of coronary events (as depicted in this slide) and total cardiovascular events (p value for trend of coronary events is 0.004 for walking, 0.008 for vigorous exercise; p value for trend of total cardiovascular events is 0.001 for both walking and vigorous exercise). * * * This observational survey of self-reported physical activity in 772 British men with CHD found that those with light or moderate activity had the lowest all-cause and cardiovascular mortality. The adjusted relative risks compared to inactive/occasionally active men were 0.42 for light activity (95% CI 0.25-0.71), 0.47 for moderate activity (95% CI, 0.24-0.92), and 0.63 for moderately vigorous/vigorous activity (95% CI 0.39-1.03). * * * In a large meta-analysis of ten randomized controlled trials, use of cardiac rehabilitation following a MI (4,347 patients total) resulted in lower rates of all-cause death (OR 0.76, 95% CI 0.63 to 0.92) and cardiovascular death (OR 0.75, 95% CI 0.62 to 0.93), with no effect on nonfatal recurrent MI. * * In this meta-analysis of 63 randomized clinical trials, participation in a secondary prevention program (including those with and without exercise) resulted in lower rates of all cause mortality and recurrent myocardial infarction. 心肺运动仪、6分钟步行试验 心脏运动康复的终点指标 两种运动试验的终点指标 Cardiology Journal, 2008 心脏康复中的运动评估 运动训练的评估指标 1. 目标心率（HR）： 静息HR +(最大HR – 静息HR) × (40–80)% 最大HR=220 – 年龄 2. 目标代谢当量：METs 代谢当量是以安静且坐位时的能量消耗为基础，表达各种活动时相对能量代谢水平的常用指标。可以用来评估心肺功能。1MET=耗氧量3.5ml/(kg·min) THANK YOU SUCCESS * * 可编辑 运动强度的另一表达指标 代谢当量（METs）： 由VO2max计算 由心电运动试验或心肺运动试验直接检测 最大METs的40%~85% 优点：用于指导日常生活活动。 注：通过运动平板和心肺运动试验可以测得 运动强度的科学计算 3、VO2max%： 心电运动实验中直接或间接计算。 50%~70% VO2max作为运动处方适宜的强度范围。 70% VO2max，持续运动中乳酸不增高，血液中肾上腺素和去甲肾上腺素保持在较低水平。 80%，则对老年