心脏康复序贯训练对冠心病预后影响的研究  

Research on the influence of cardiac rehabilitation sequential exercise on prognosis of coronary heart disease

作　　者：庞明[1] 史文[1] 关浩增[1] 陈敏[1] 李维[1] 严红[1] 苏卫红[1] 周芸[1] 陆丽娟[1] 

机构地区：[1]广西壮族自治区江滨医院心内科,南宁530021

出　　处：《中国临床新医学》2011年第3期198-201,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西科技厅自然基金资助项目(编号:桂科自0832199)

摘　　要：目的探讨心脏康复运动训练对冠心病患者预后的影响。方法选择住院治疗的冠心病患者102例,诊断标准按《WHO 1979年冠心病的诊断标准》,排除心功能三级以上及关节、下肢有疾患的患者,按入院先后单双号分别分到康复组和对照组,每组51例,两组分别进行血压、血脂、心电图、心脏B超、颈动脉B超、心电图活动平板负荷试验和6 min步行试验等检查。康复组患者进行心功能评估后,按照个体化的康复运动训练处方进行有指导的康复运动训练,对照组不予运动指导。24周后对全部项目进行复查。结果观察期间两组无因意外退出观察病例;康复组患者大部分病例心绞痛发作减少,其中有32例无心绞痛发作(P<0.01);心电图大多有改善,其中16例心电图ST-T转为正常(P<0.01);血压、室间隔(IVS)、左室后壁(IVW)、总胆固醇(TC)、低密度脂蛋白(LDL)、颈动脉内膜厚度及斑块均有改善(P<0.01),6 min步行距离和运动代谢当量也有改善(P<0.01)。康复组与对照组相比,除LDL外(P<0.05),TC、EF、颈动脉斑块、6 min步行距离均有统计学意义(P<0.01)。结论冠心病患者经过有指导的和个性化的康复运动训练后,对改善心功能、改善冠心病的预后,提高运动耐力有好处。Objective To observe the effect of cardiac rehabilitation exercise training on prognosis of coronary heart disease. Methods One hundred and two inpatients in accord with diagnostic criteria for coronary heart disease developed by WHO in 1979 excluding patients with class Ⅲ or more, and patients with joint or lower extremity disease, successively by odd and even numbers on admission were assigned to rehabilitation group and control group, 51 patients in each group, blood pressure, lipids, electrocardiogram, eehocardiography, carotid tdtrasound, ECG treadmill stress test and 6-minnte walking test and other tests were perfomed in two groups. After evaluation of cardiac function, rehabilitation group received supervised rehabilitation exercise training in aeeorelanee with individualized rehabilitation exercise training prescription, control group did not receive movement guidance. All items were reviewed after 24 weeks. Results During the observation of the two groups no one quit because of an accident. After exercise traning, angina pectoris signiiicartly reduced in patients with angina pectoris in rehabilitation group, with 32 patients without angina （P 〈 0. 01 ）. ECG were improved, with patients with ST-T to normal （P 〈 0. 01 ）. Blood pressure, ventricular septal, left ventricular posterior wall, TC, LDL, carotid intima-media thickness and plaque improved （P 〈 0. 01 ）, 6 rain walking distance and metabolic equivalent increased （P 〈 0. 01 ）. Except LDL, there were statistical difference in TC, EF,6 min walking distance and carotid plaque between two groups. Conclusion A guided and individualized rehabilitation exercise training is helpful in improving heart function, the prognosis of coronary heart disease and exercise tolerance for patients with coronary heart disease.

关 键 词：冠心病 康复 运动 

分 类 号：R541.4[医药卫生—心血管疾病]