冠心病患者体成分与运动能力的相关性  

Correlation between body composition and exercise capacity in patients with coronary heart disease

作　　者：白瑾[1] 赵威[1] 徐昕晔[1] 刘萍[1] 王鸿艳[1] 吴晓月[1] 李刘宁 高炜[1] 

机构地区：[1]北京大学第三医院心内科卫生部心血管分子生物学与调节肽重点实验室分子心血管学教育部重点实验室,北京100191

出　　处：《北京大学学报（医学版）》2014年第6期854-858,共5页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(81030001)资助~~

摘　　要：目的：应用人体成分分析仪测定冠心病患者的体成分,分析患者体成分与运动能力的关系,为更准确地评估患者身体成分,预测患者的运动能力及指导其后期康复运动提供依据.方法：入选2013年12月至2014年8月期间,就诊于北京大学第三医院心内科接受经皮腔内冠状动脉介入治疗（percutaneous coronary intervention,PCI）且心功能Ⅰ～Ⅱ级（NYHA分级）的冠心病患者663例,术后15～20 d内完成运动心肺功能评定（应用BRUCE平板运动方案,进行症状限制性平板运动试验）.在运动前应用Inboby720人体成分分析仪对患者进行体成分测定.结果：663例冠心病患者均完成体成分测定及运动心肺功能评定.依据体重指数（body mass index,BMI）、体脂百分比（percentage of body fat,PBF）、腰臀比（waist-hip ratio,WHR）这3个指标诊断肥胖,其检出率分别为22.8％、63.3％和72.7％,仅有PBF与患者的运动能力呈负相关性（r=-0.306,P＜0.001）.依据PBF分组,肥胖组较非肥胖组患者的运动能力下降,差异具有统计学意义（P＜0.01）.依据运动心肺功能评定代谢当量（metabolic equivalent ofenergy,METs）将患者分为低、中、高运动功能储备组,只有PBF在3组患者中差异具有统计学意义（P＜0.05）.结论：应用人体成分分析仪测定的PBF诊断肥胖更为准确,且与患者的运动能力呈负相关,是冠心病患者运动能力预测与指导康复运动的重要指标.Objective：To provide the evidence for more accurately assessing the patient＇ s body composition,predicting exercise capacity and guiding rehabilitation exercise by analyzing the body compositions in patients with coronary heart disease,and to study the correlation between body compositions and exercise capacity.Methods：The study enrolled 663 patients with coronary heart disease in NYHA Ⅰ-Ⅱ stages,who underwent coronary intervention therapy between December 2013 and August 2014.Between 15th and 20th days of the onset,cardiopulmonary exercising testing （CPET,Bruce Protocol） was conducted,and the body composition was measured with the Inboby720 body composition analyzer before CPET.Results：All the patients completed the body composition evaluation and the CPET.According to the three indicators of body mass index （BMI）,percentage of body fat （PBF）,waist-hip ratio （WHR）,the diagnostic rate of obesity was 22.8％,63.3％,and 72.7％,respectively.There was a good negative correlation between PBF and exercise capacity （r =-0.306,P ＜ 0.001）.Compared with non-obesity patients,the exercise capacity of obesity group decreased according to PBF （P ＜ 0.01）.The patients were divided into low,moderate and high exercise capacity groups according to METs,and the difference was only the PBF among the three groups （P ＜ 0.05）.Conclusion：PBF,measured by body composition,is a more accurate diagnosis of obesity and has a good negative correlation with exercise capacity,which can be used as an important indicator to predict the exercise capacity in patients with coronary heart disease and guide the rehabilitation exercise.

关 键 词：冠心病 体成分 运动能力 电阻抗 

分 类 号：R541.4[医药卫生—心血管疾病]