基于心肺运动试验指导冠状动脉旁路移植术后患者有氧运动康复训练并评估对心肺功能的影响  

Aerobic exercise rehabilitation training and evaluation of cardiopulmonary function improvement in patients with coronary artery bypass grafting during perioperative period based on cardiopulmonary exercise test

作　　者：刘晓配 邢凤英 王英慧 杨璐 沈青青 Liu Xiaopei;Xing Fengying;Wang Yinghui;Yang Lu;Shen Qingqing(Department of Cardiac rehabilitation,Xingtai Central Hospital,Hebei Xingtai 054000,China)

机构地区：[1]邢台市中心医院心脏康复科,邢台054000

出　　处：《中国体外循环杂志》2025年第2期140-144,147,共6页Chinese Journal of Extracorporeal Circulation

基　　金：邢台市重点研发计划项目(2023ZC088)。

摘　　要：目的研究心肺运动试验(CPET)对冠状动脉旁路移植术(CABG)患者围手术期有氧运动康复训练的指导作用以及对患者心肺功能的影响。方法选择在本院进行CABG患者148例,以随机数字法分为观察组和对照组各74例。应用CPET对患者心肺功能进行测试。2组患者经过CABG治疗后,除常规护理和基础治疗外,同时对患者进行心脏运动功能训练。观察组患者在此基础上进行有CPET评估的有氧运动,其中以无氧阈前一分钟的功率作为运动负荷。对患者心功能、CPET、运动能力和肌钙蛋白I(cTnI)、脑钠肽(BNP)和心型脂肪酸结合蛋白(FABP)表达进行检测。结果干预后,两组患者均有明显增强的心功能指标,而且观察组的心功能相对于对照组强(P<0.05);对两组患者峰值氧脉搏、峰值摄氧量和无氧阈变化进行对比,观察组患者的峰值氧脉搏、峰值摄氧量和无氧阈均较术前有所提升(P<0.05);观察组患者的峰值氧脉搏、峰值摄氧量和无氧阈提高人数多于对照组(P<0.05)。经过干预后,两组患者的cTnI、BNP、FABP水平均有降低,且观察组患者的cTnI、BNP、FABP水平均低于对照组(P<0.05)。结论应用CPET指导CABG围手术期患者有氧运动康复训练效果良好,能够有效提升患者心肺功能,改善患者血清cTnI、BNP和FABP表达。Objective To explore the guiding role of cardiopulmonary exercise testing(CPET)in guiding perioperative aerobic exercise rehabilitation training of patients with coronary artery bypass grafting(CABG)and its effect on cardiopulmonary function.Methods A total of 148 CABG patients in the hospital were selected and randomly divided into observation group and control group,74 cases in each group.CPET was used to assess cardiopulmonary function.Both groups received routine care and standard treatment post-CABG,along with cardiac functional exercise training.The observation group patients underwent aerobic exercise with CPET assessment based on this,with the power at the anaerobic threshold one minute before being set as 80%of the peak power value obtained from the CPET assessment as the exercise load.The cardiac function,CPET,exercise ability and cardiac troponin I(cTnI),brain natriuretic peptide(BNP)and heart fatty acid binding protein(FABP)expression were detected.Results After intervention,cardiac function improved significantly in both groups,with superior outcomes in the observation group compared to the control group(P<0.05).The observation group exhibited significant improvements in peak oxygen pulse,peak oxygen consumption and anaerobic threshold compared to pre-surgery levels,(P<0.05)and outperformed the control group in these measures(P<0.05).Levels of cTnI,BNP and FABP decreased in both groups after the intervention,with the observation group showing significantly lower levels than the control group(P<0.05).Conclusion CPET-guided aerobic exercise rehabilitation during the perioperative period of CABG is effective in improving cardiopulmonary function of patients and reducing serum cTnI,BNP,and FABP levels in patients.

关 键 词：心肺运动试验 冠状动脉旁路移植术 有氧运动 心肺功能 术后康复 

分 类 号：R473.6[医药卫生—护理学]