6分钟步行试验在稳定性冠心病患者社区心脏康复中的应用  

Application of 6-minute walk test in community-based cardiac rehabilitation of patients with stable coronary artery disease

作　　者：杨玲[1] 杜雪平[1] YANG Ling;DU Xueping(Department of General Practice,Yuetan Community Health Service Center,Fuxing Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属复兴医院月坛社区卫生服务中心全科医学科,北京100045

出　　处：《中华全科医学》2023年第8期1356-1359,共4页Chinese Journal of General Practice

基　　金：首都卫生发展科研专项(首发2018-3-7023)。

摘　　要：目的通过分析稳定性冠心病患者运动康复前后6分钟步行距离(6MWD)变化,评估运动康复效果。方法2021年6月-2022年6月从月坛社区卫生服务中心规范管理的、75岁以下稳定性冠心病患者中招募试验组和对照组各50例,试验组采用功率自行车进行运动康复,每例受试者蹬功率自行车总计30次,每次20 min,每周3~5次,对照组为散步等低强度运动,每次30~60 min,每周3~5次。观察指标为干预前后的6MWD,采用χ^(2)检验对试验组和对照组干预前后效果进行评价。结果按6MWD对应的心肺功能分级,“≤300 m”为“1~2级”,“≥301 m”为“3~4级”。试验组和对照组干预后心肺功能分级比较,差异有统计学意义(χ^(2)=21.951,P<0.001)。将试验组、对照组干预前后6MWD增长(Δ6MWD)分组为“<54 m”和“≥54 m”,试验组、对照组Δ6MWD分级比较,差异有统计学意义(χ^(2)=96.078,P<0.001)。结论稳定性冠心病患者使用功率自行车运动康复后6MWD增加,心肺功能分级提高,可为今后冠心病患者社区心脏康复提供重要参考。Objective To evaluate the effect of exercise rehabilitation by analyzing the 6-minute walking distance(6MWD)of patients with stable coronary artery disease before and after exercise rehabilitation.Methods Fifty patients in the experimental group and 50 patients in the control group were recruited from patients with stable coronary artery disease under the age of 75 years under standard management from June 2021 to June 2022 of the Yuetan Community Health Service Center.The experimental group underwent exercise rehabilitation,which consisted of exercise bicycle training.Each subject pedaled an exercise of bicycle for 30 times,20 minutes each time,3-5 times a week.The control group used low-intensity exercise such as walking,3-5 times a week,30-60 minutes each time.The observation index was 6MWD before and after intervention.The effects of the experimental group and the control group before and after intervention were evaluated by chi-square test.Results According to the cardiopulmonary function classification corresponding to 6MWD,"≤300 m"was"Level 1 to 2"and"≥301 m"was"Level 3 to 4".There was a statistically significant difference in cardiopulmonary function grading between the experimental group and the control group after intervention(χ^(2)=21.951,P<0.001).The increase of 6MWD(Δ6MWD)before and after the intervention were grouped as"<54 m"and"≥54 m"in the experimental and control groups,and the difference was statistically significant when comparing theΔ6MWD grading in the test and control groups(χ^(2)=96.078,P<0.001).Conclusion The 6MWD and cardiopulmonary function grading of patients with stable coronary artery disease were increased after exercise rehabilitation with an exercise bicycle,which may provide an important reference for community cardiac rehabilitation of patients with coronary artery disease in the future.

关 键 词：心脏康复 6分钟步行试验 稳定性冠心病患者 

分 类 号：R541.4[医药卫生—心血管疾病]