基于心肺运动试验的运动康复模式在冠心病治疗及康复中的应用价值  

Application value of exercise rehabilitation mode based on CPET in the treatment and rehabilitation of coronary heart disease

作　　者：王肖雅 周小丽 薛明月 姜美琴 WANG Xiao-ya;ZHOU Xiao-li;XUE Ming-yue;JIANG Mei-qin(Respiratory Medicine Department,Hai'an People's Hospital,Nantong,Jiangsu,226600,China)

机构地区：[1]海安市人民医院呼吸内科,江苏南通226600

出　　处：《心血管康复医学杂志》2025年第1期22-26,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探究基于心肺运动试验(CPET)的运动康复模式在冠心病治疗及康复中的应用价值。方法:选择2021年1月-2022年6月海安市人民医院收治的260例冠心病患者,按照随机数字表法分为对照组(130例,常规护理)和干预组(130例,对照组基础上实施运动康复训练护理)。干预6个月后,比较两组患者心脏健康自我效能和自我管理(HH-SESM)量表、中国心血管病人生活质量评定问卷(CQQC)评分、氧代谢指标峰值摄氧量(VO_(2peak))、峰值摄氧量占预计值的百分比(VO_(2peak)%Pred)、峰值代谢当量(peak Mets)、心功能指标,以及不良事件发生率。结果:干预后,与对照组比较,干预组HH-SESM[(76.57±5.88)分比(64.51±5.16)分]、CQQC量表[(111.66±7.93)分比(84.16±6.96)分]总分和VO_(2peak)[(1.41±0.11)L/min比(1.19±0.26)L/min]、VO_(2peak)%Pred[(59.32±3.51)%比(51.27±3.11)%]、peak Mets[(7.89±1.86)比(5.22±1.16)]、6MWD[(473.53±18.12)m比(354.27±23.11)m]均显著增加,血清N末端脑钠肽前体(NT-proBNP)[(5.13±2.17)pg/ml比(13.81±2.22)pg/ml],心肌肌钙蛋白I(cTnI)[(2.90±0.51)ng/ml比(4.76±1.32)ng/ml]水平均显著降低(P均<0.001)。干预组不良事件发生率显著低于对照组(3.85%比13.85%,P=0.005)。结论:基于CPET的运动康复治疗可有效改善冠心病患者的自我效能和自我管理、生活质量、心肺功能,降低不良事件风险。Objective:To investigate the application value of exercise rehabilitation mode based on cardiopulmonary exercise testing(CPET)in the treatment and rehabilitation of coronary heart disease(CHD).Methods:This randomized controlled study enrolled 260 CHD patients admitted in Hai'an People's Hospital between January 2021 and June 2022.They were divided into control group(n=130,routine nursing)and intervention group(n=130,additional exercise rehabilitation training nursing).After 6-month intervention,scores of Heart Health-Self-Efficacy and Self-Management(HH-SESM)scale,Chinese Quality of Life Questionnaire for Cardiovascular Patients(CQQC),peak oxygen uptake(VO_(2peak)),percentage of peak oxygen uptake in predicted maximum(VO 2peak%Pred),peak metabolic equivalent(peak Mets),cardiac function indexes,and incidence of adverse events were compared between two groups.Results:After intervention,compared with patients in control group,those in intervention group had significant higher scores of HH-SESM[(76.57±5.88)points vs.(64.51±5.16)points]and CQQC[(111.66±7.93)points vs.(84.16±6.96)points],VO_(2peak)[(1.41±0.11)L/min vs.(1.19±0.26)L/min],VO_(2peak)%Pred[(59.32±3.51)%vs.(51.27±3.11)%],peak Mets[(7.89±1.86)vs.(5.22±1.16)],6MWD[(473.53±18.12)m vs.(354.27±23.11)m],and significant lower serum N-terminal pro brain natriuretic peptide(NT-proBNP)[(5.13±2.17)pg/ml vs.(13.81±2.22)pg/ml],cardiac troponin I(cTnI)[(2.90±0.51)ng/ml vs.(4.76±1.32)ng/ml](P<0.001 all).Intervention group had significant lower incidence of adverse events comparing to control group(3.85%vs.13.85%,P=0.005).Conclusion:Exercise rehabilitation treatment based on cardiopulmonary exercise test could effectively improve self-efficacy and self-management,quality of life,cardiopulmonary function and reduce risk of adverse events in patients with coronary heart disease.

关 键 词：冠心病 生活质量 运动试验 

分 类 号：R541.4[医药卫生—心血管疾病]