心脏康复对冠心病患者心肺耐力改善率的影响  

Improvement rate of cardiorespiratory endurance in patients with coronary heart disease by standardized cardiac rehabilitation

作　　者：周淋[1] 张福春[1,2] 楚新梅[1] 张小洺 刘志霆 陈磊 马佳[1] Zhou lin;Zhang fuchun;Chu xinmei;Zhang xiaoming;Liu zhiting;Chen lei;Ma jia(Beijing Haidian Hospital,Beijing,100080,China;Peking University Third Hospital,Beijing,100191,China)

机构地区：[1]北京市海淀医院,100080 [2]北京大学第三医院,100191

出　　处：《临床心电学杂志》2022年第2期131-135,共5页Journal of Clinical Electrocardiology

摘　　要：目的 探讨以运动康复为核心的心脏康复方案对稳定性冠心病患者无氧阈和峰值摄氧量等运动耐力指标改善率的影响。方法 选择2018年6月至2021年8月间在北京市海淀医院临床诊断为稳定性冠心病患者89例,按患者意愿分为对照组(n=24)和心脏康复组(n=65)。对照组患者进行冠心病标准治疗,心脏康复组患者进行12周心脏康复,由专业康复医护人员负责指导和随访观察12周。入组时及治疗12周后分别评估患者症状限制性的心肺运动试验(CPET)指标。结果 组间比较,治疗前心脏康复组摄氧效率斜率百分比(83.29±16.57 vs. 72.33±11.98)显著高于对照组(p<0.05)。治疗后心脏康复组无氧阈摄氧量(1010.78±228.52 vs. 895.42±210.89ml/min)、峰值摄氧量(1635.09±417.59 vs. 1528.92±376.95ml/min)以及摄氧效率斜率百分比(86.57±15.61 vs. 71.44±11.16)均高于对照组,并且差异有统计学意义(p<0.05)。改善率方面心脏康复组治疗后无氧阈摄氧量(5.10±11.75 vs.-1.32±14.96ml/min)、峰值摄氧量(8.75±11.22 vs.-0.13±12.78ml/min)、峰值运动功率(7.84±13.63 vs.-0.17±13.28)和摄氧效率斜率百分比(4.92±11.20 vs.-0.54±10.83)的改善率均高于对照组,并且差异有统计学意义(p<0.05)。组内比较,对照组患者无氧阈摄氧量、峰值摄氧量等治疗前后无明显差异(p>0.05)。心脏康复组无氧阈摄氧量、峰值摄氧量、峰值运动功率、氧功率斜率、摄氧效率斜率百分比治疗后较入组时升高,并且差异有统计学意义(p<0.05)。结论 标准化运动康复可提高稳定性冠心病患者以峰值摄氧量、无氧阈摄氧量为主要指标的心肺运动耐力,使得峰值摄氧量、无氧阈摄氧量、峰值运动功率和摄氧效率斜率百分比等主要CPET运动耐力指标均有不同程度的提高(4.92%-8.75%),尤其是峰值摄氧量升高最明显。Objective To explore the effect of a heart rehabilitation program with exercise rehabilitation as the core on the improvement rate of exercise endurance indicators such as anaerobic threshold and peak oxygen uptake in patients with stable coronary heart disease. Methods A total of 89 patients with stable coronary heart disease who were clinically diagnosed in Beijing Haidian Hospital from June 2018 to August 2021 were selected and divided into control group(n=24) and cardiac rehabilitation(CR) group(n=65) according to patients’ wishes. The patients in the control group received standard coronary heart disease treatment.Patients in the CR group underwent 12-week rehabilitation, and were guided and followed up for 12 weeks by professional rehabilitation medical staff.Symptom-limited cardiopulmonary exercise test(CPET) indicators were assessed at enrollment and after 12 weeks of treatment. Results Compared between groups, the percentage of oxygen uptake efficiency slope in the CR group(83.29±16.57 vs. 72.33±11.98) was significantly higher than that in the control group before treatment(p<0.05). After treatment, the anaerobic threshold oxygen uptake(1010.78 ±228.52 vs. 895.42 ±210.89ml/min), peak oxygen uptake(1635.09 ±417.59 vs. 1528.92 ±376.95ml/min) and the percentage of oxygen uptake efficiency slope(86.57±15.61 vs. 71.44 ±11.16) in the CR group were all higher than those in the control group, and the difference was statisticallysignificant(p<0.05). In terms ofimprovement rate, the improvement rates ofanaerobic threshold oxygen uptake(5.10±11.75 vs.-1.32±14.96ml/min), peak oxygen uptake(8.75±11.22 vs.-0.13±12.78ml/min), peak exercise power(7.84 ±13.63 vs.-0.17 ±13.28) and oxygen uptake efficiency slope percentage(4.92 ±11.20 vs.-0.54 ±10.83) after treatment in the CR group were all higher than those in the control group, and the difference was statistically significant(p<0.05). Within-group comparison shows there was no significant difference in anaerobic threshold oxygen uptake and peak oxygen

关 键 词：稳定性冠心病 心脏康复 运动康复 心肺运动试验 改善率 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]