心脏康复运动训练对冠心病经皮冠状动脉介入治疗术后患者心肺功能、心肺耐力及日常生活能力的影响  

Effects of cardiac rehabilitation exercise training on cardiopulmonary function,cardiopulmonary endurance and daily living ability in patients with coronary heart disease after percutaneous coronary interventional therapy

作　　者：朱苑芳 黄旭梅 卞乐乐 季晓君 Zhu Yuanfang;Huang Xumei;Bian Lele;Ji Xiaojun(Department of Cardiovascular Medicine,Wenzhou Central Hospital,Wenzhou 325000,China;Department of Geriatric Medicine/Cadre Health,Wenzhou Central Hospital,Wenzhou 325000,China)

机构地区：[1]温州市中心医院心血管内科,温州325000 [2]温州市中心医院老年医学科/干部健康科,温州325000

出　　处：《中国医师进修杂志》2024年第12期1093-1097,共5页Chinese Journal of Postgraduates of Medicine

基　　金：温州市科技计划项目(Y20210833)。

摘　　要：目的探讨心肺运动试验(CPET)指导下的心脏康复运动训练对冠心病经皮冠状动脉介入治疗(PCI)术后患者心肺功能、心肺耐力及日常生活能力的影响。方法前瞻性选择温州市中心医院2022年7月至2023年5月经冠状动脉造影诊断为冠心病,并行PCI的患者70例(3例患者最终退出研究),按随机数字表法分为对照组(33例)和康复组(34例),对照组予以PCI后的基础药物治疗,康复组在对照组治疗的基础上,予以为期12周的心脏康复运动训练,比较两组治疗前后心肺功能、心肺耐力指标及日常生活能力(ADL)评分。结果康复组患者经过12周心脏康复运动训练,心肺功能指标左室舒张末期容积、左室收缩末期容积、左房内径、左室舒张末期内径、左室射血分数、第1秒用力呼气容积(FEV 1)、FEV 1占用力呼气容积(FVC)比值、最大通气量与对照组比较均显著改善[(102.8±14.4)ml比(114.8±20.4)ml、(39.9±13.7)ml比(48.4±16.9)ml、(37.1±3.4)mm比(38.9±3.6)mm、(50.3±3.6)mm比(52.5±4.7)mm、(64.0±6.8)%比(59.6±6.5)%、(2.39±0.38)L比(2.10±0.26)L、(77.7±4.0)%比(73.8±4.3)%、(101.6±18.7)L/min比(89.6±11.1)L/min],差异有统计学意义(P<0.05)。康复组患者经过12周心脏康复运动训练,心肺耐力指标峰值摄氧量(VO 2peak)、千克体质量峰值摄氧量、无氧阈、峰值代谢当量、最大运动负荷与对照组比较均显著改善[(1441.8±251.9)ml/min比(1272.5±207.0)ml/min、(20.7±3.6)ml/(min·kg)比(18.2±2.5)ml/(min·kg)、(1346.8±201.3)ml/min比(1075.4±176.7)ml/min、(5.9±1.1)Met比(5.2±0.7)Met、(107.3±29.1)Watt比(88.4±17.8)Watt],差异有统计学意义(P<0.05)。康复组治疗后ADL评分高于对照组[(90.9±8.1)分比(85.6±11.6)分],差异有统计学意义(P<0.05)。结论在心肺运动试验指导下进行心脏康复运动,对冠心病PCI术后患者的心肺功能、心肺耐力、日常生活自理能力有明显的改善作用。ObjectivesTo investigate the effect of cardiac rehabilitation exercise guided by cardiopulmonary exercise test on cardiopulmonary function,cardiopulmonary endurance and activities of daily living in patients who had coronary heart disease after percutaneous coronary intervention(PCI).MethodsSeventy patients who had coronary heart disease after PCI treated in the Wenzhou Central Hospital from July 2022 to May 2023 were enrolled perspectively(3 cases eventually dropped out of the study),and they were divided into the control group(33 cases)and the rehabilitation group(34 cases)by random number table method.The control group was given conventional medication after PCI,while the rehabilitation group was additionally provided with exercise rehabilitation for 12 weeks on the basis of the control group.The patient′s cardiopulmonary function indicators,cardiopulmonary endurance indicators and ability of daily living(ADL)score of the two groups were compared before and after treatment.ResultsAfter treatment for 12 weeks,the cardiopulmonary function indicators left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left atrial inner diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),forced expiratory volume in the first second(FEV 1),ratio of FEV 1 to forced expiratory volume(FVC)(FEV 1/FVC),maximum ventilation quantity(MVV)in the rehabilitation group were obviously improved compared with the control group:(102.8±14.4)ml vs.(114.8±20.4)ml,(39.9±13.7)ml vs.(48.4±16.9)ml,(37.1±3.4)mm vs.(38.9±3.6)mm,(50.3±3.6)mm vs.(52.5±4.7)mm,(64.0±6.8)%vs.(59.6±6.5)%,(2.39±0.38)L vs.(2.10±0.26)L,(77.7±4.0)%vs.(73.8±4.3)%,(101.6±18.7)L/min vs.(89.6±11.1)L/min,there were statistical differences(P<0.05).After treatment for 12 weeks,the cardiopulmonary endurance indicators peak oxygen uptake(VO 2peak),peak oxygen uptake per kilogram of body weight(VO 2peak/kg),anaerobic threshold(AT),peak metabolic equivalent(METspeak),maximum working load(MW

关 键 词：冠状动脉疾病 经皮冠状动脉介入治疗 心脏康复 心肺运动试验 心肺功能 

分 类 号：R541.4[医药卫生—心血管疾病]