基于CPET制定的运动康复对ACS患者冠脉介入术后的影响  

Effect of exercise rehabilitation based on CPET after percutaneous coronary intervention in ACS patients

作　　者：张红岩[1] 于蕾 李春峰[1] 薛探[1] 姜巍娇[1] 孙婷婷[1] 历成霖 Zhang Hongyan;Yu Lei;Li Chunfeng;Xue Tan;Jiang Weijiao;Sun Tingting;Li Chenglin(The Second Affiliated Hospital of Qiqihar Medical University,Qiqihar,Heilongjiang 161000,China;Graduate School of Qiqihar Medical University,Qiqihar,Heilongjiang 161000,China)

机构地区：[1]齐齐哈尔医学院第二附属医院,黑龙江齐齐哈尔161000 [2]齐齐哈尔医学院

出　　处：《齐齐哈尔医学院学报》2024年第23期2251-2254,共4页Journal of Qiqihar Medical University

基　　金：齐齐哈尔市科技计划联合引导项目(LHYD-2021111)。

摘　　要：目的 通过心脏超声和心肺运动试验(CPET)评估急性期接受经皮冠状动脉介入(PCI)治疗的急性冠脉综合征(ACS)患者进行运动训练为主的心脏康复,研究ACS患者从运动康复中的临床受益。方法 选择2022年6月-2024年5月本院收治的PCI术后的ACS患者70例作为研究对象,随机数表法分为对照组和观察组两组,每组各35例。对照组患者于PCI术后给予患者常规康复训练干预,观察组患者于PCI术后实施心肺康复运动干预,两组患者康复训练干预周期均为12周。分别于干预前、干预12周后采用心肺功能检测仪测定两组患者心肺功能指标;采用彩色多普勒超声诊断仪测定两组患者心脏功能指标,进行比较分析。结果 干预12周后,两组患者最大氧脉搏、峰值千克摄氧量、无氧阈摄氧量等均明显高于本组干预前,差异有统计学意义(P<0.05),且观察组患者最大氧脉搏、峰值千克摄氧量、无氧阈摄氧量均明显高于对照组各数值,差异有统计学意义(P<0.05)。两组患者运动训练后LVEF明显大于训练前,LVEDD均显著下降,差异有统计学意义(P<0.05)。运动训练后,观察组患者LVEF明显大于对照组,LVEDD明显低于对照组,差异有统计学意义(P<0.05)。结论 对经PCI治疗并在恢复期的ACS患者,给予运动康复,能使患者在心脏收缩功能和运动耐量方面得到的进一步改善。Objective To evaluate the effects of exercise-based cardiac rehabilitation on patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI)using echocardiography and cardiopulmonary exercise testing(CPET),and to investigate the clinical benefits of exercise rehabilitation in ACS patients.Methods A total of 70 ACS patients who underwent PCI at our hospital from June 2022 to May 2024 were selected as the study subjects and randomly divided into a control group and an observation group,each with 35 cases.The control group received routine rehabilitation training intervention after PCI,while the observation group received cardiopulmonary rehabilitation exercise intervention after PCI.The rehabilitation training intervention period for both groups was 12 weeks.Cardiopulmonary function indicators were measured using a cardiopulmonary function detector before and after the 12-week intervention;cardiac function indicators were measured using a color Doppler ultrasound diagnostic instrument.Results After the 12-week intervention,the maximal oxygen pulse,peak kilogram oxygen uptake,and anaerobic threshold oxygen uptake in both groups were significantly higher than before the intervention(P<0.05),and these values in the observation group were significantly higher than those in the control group(P<0.05).Both groups showed a significant increase in left ventricular ejection fraction(LVEF)and a significant decrease in left ventricular end-diastolic diameter(LVEDD)after exercise training compared to before training(P<0.05).The LVEF in the observation group was significantly higher,and LVEDD was significantly lower than in the control group after exercise training(P<0.05).Conclusions Exercise rehabilitation for ACS patients post-PCI during the recovery period can further improve cardiac systolic function and exercise tolerance.

关 键 词：急性冠脉综合征 心脏康复 心肺运动试验 

分 类 号：R541.4[医药卫生—心血管疾病]