冠心病经皮冠状动脉介入治疗术后患者运动耐量的临床研究  

Clinical study on the exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention

作　　者：高姗 曹瑞华[1] 王盛书 芦婷婷 李苏雷[1] 白永怿[1] 陈海威[3] 李彦华[4] 徐勇 曹丰[1] GAO Shan;CAO Rui-hua;WANG Sheng-shu;LU Ting-ting;LI Su-lei;BAI Yong-yi;CHEN Hai-wei;LI Yan-hua;XU Yong;CAO Feng(Department of Cardiology,Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Institute of Geriatrics,Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Geriatrics,Fourth Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Cardiology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Beijing key laboratory of chronic heart failure precision medicine,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心心血管内科,北京市100853 [2]解放军总医院第二医学中心老年医学研究所 [3]解放军总医院第四医学中心老年医学科 [4]解放军总医院第一医学中心心血管内科 [5]慢性心衰精准医学北京市重点实验室

出　　处：《中国心血管病研究》2021年第4期313-318,共6页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金重大研究计划(91939303);2019解放军总医院军事医学创新项目(CX19028)。

摘　　要：目的探究冠心病经皮冠状动脉介入治疗(PCI)术后康复期患者不同舒张压(DBP)水平下的运动耐量情况。方法选取2019年10月至2020年10月就诊于解放军总医院心血管内科的45例冠心病PCI术后患者,其中男性35例,女性10例,平均年龄(61.69±9.73)岁,按6分钟步行距离(6MWD)水平进行分组,应用独立样本t检验及χ^(2)检验比较两组基线资料,Spearman相关性检验和二元logistic回归分析DBP与6MWD的关系。结果二元logistic回归分析结果提示,校正性别、年龄、BMI、每周运动时间、吸烟习惯、糖尿病和高脂血症后,随DBP的增加,6MWD减低的风险增加(OR=1.117,95%CI 1.014~1.231,P=0.025);分层分析结果提示,在中年组和非糖尿病组中,随DBP的增加,6MWD减低的风险增加(中年组:OR=1.317,95%CI1.059~1.638,P=0.013);非糖尿病组:OR=1.143,95%CI 1.015~1.288,P=0.028)。结论冠心病PCI术后人群中,特别是在中年和非糖尿病人群中,DBP与6MWD减低风险存在相关性,随DBP升高,6MWD减低的风险增加。Objective To investigate the correlation between the exercise tolerance and DBP level in CHD patients after PCI.Methods A total of 45 CHD patients after PCI who were admitted to the Department of Cardiology at the Chinese PLA General Hospital from October 2019 to October 2020 were enrolled in this study.Of these patients,35 were male.The mean age of the subjects was(61.69±9.73)years.The subjects were divided into two groups based on 6 MWD.Student-t test and Chi-square test were applied to compare the baseline data.Spearman correlation coefficients between 6 MWD and other indexes were calculated.Besides,binary logistic regression models were used to evaluate the correlation between DBP and the risk of 6 MWD reduction.Results Binary logistic regression analysis suggested that the risk of 6 MWD reduction was negatively associated with DBP after gender,age,BMI,weekly exercise time,smoking habit,DM and HLP being adjusted(OR=1.117,95%CI1.014~1.231,P=0.025).Stratified analysis indicated that the risk of 6 MWD reduction increased with DBP elevation in middle-aged group(OR=1.317,95%CI 1.059-1.638,P=0.013)and non-diabetic group(OR=1.143,95%CI 1.015~1.288,P=0.028).Conclusion In CHD patients after PCI,the risk of 6 MWD reduction increases with DBP elevation,especially in middle-aged and non-diabetic subjects.

关 键 词：冠心病 经皮冠状动脉介入治疗术 舒张压 六分钟步行距离 运动耐量 

分 类 号：R541.4[医药卫生—心血管疾病]