门诊或居家心脏康复训练对中青年冠心病患者经皮冠状动脉介入术后心肺功能和心理的影响  

Effect of outpatient or home-based cardiac rehabilitation training on cardiopulmonary function and mental health after percutaneous coronary intervention in young and middle-aged patients with coronary heart disease

作　　者：李婧媛 李海英 郭晓 曲凤霞 辛越 周亚群 LI Jingyuan;LI Haiying;GUO Xiao;QU Fengxia;XIN Yue;ZHOU Yaqun(Department of Cardiology,Qingdao Cardiovascular Hospital,Qingdao 266034,China)

机构地区：[1]青岛心血管病医院心内科,山东青岛266034

出　　处：《精准医学杂志》2025年第2期173-177,共5页Journal of Precision Medicine

基　　金：山东省青岛市科技惠民示范引导专项(21-1-4-rkjk-21-nsh)。

摘　　要：目的探讨门诊或居家心脏康复训练对中青年冠心病患者经皮冠状动脉介入术(PCI)后心肺功能及心理的影响。方法选择2020年1月—2021年12月于我院PCI术后患者110例,随机分为居家组(56例)和门诊组(54例)。根据CPET评估结果,制定个体化康复训练处方,门诊组患者在医院门诊进行心脏康复训练,居家组患者进行居家心脏康复训练,记录两组患者在训练前和训练3个月时心肺运动测试结果、广泛性焦虑自评量表(GAD-7)评分和9项患者健康抑郁量表(PHQ-9)评分,并对两组患者训练前后各项指标差值进行比较。结果两组患者康复训练后的无氧阈功率(ATPower)、无氧阈代谢当量(ATMets)、无氧阈每公斤摄氧量(ATVO_(2))、峰值功率(PEAKPower)、峰值每公斤摄氧量(PEAKVO_(2) max)、峰值代谢当量(PEAKMets)较训练前均明显增加(t=2.22~6.43,P<0.05);两组患者安静心率、安静收缩压、安静舒张压较训练前差异无显著性(P>0.05),两组患者训练前后的ATMets、ATVO_(2)、PEAKMets、PEAKPower、PEAKVO_(2) max的差值比较差异有显著性(z=2.23~4.10,P<0.05)。两组患者康复训练后GAD-7评分与PHQ-9评分均较康复前显著降低(t=5.82~8.59,P<0.05),但两组训练前后的GAD-7评分、PHQ-9评分差值比较差异无显著性(P>0.05)。结论门诊和居家心脏康复训练均能够提高中青年冠心病患者PCI术后心肺功能,[JP3]可缓解患者焦虑、抑郁情绪,但门诊心脏康复训练的效果优于居家训练。Objective To investigate the effect of outpatient or home-based cardiac rehabilitation training on cardiopulmonary function and mental health after percutaneous coronary intervention(PCI)in young and middle-aged patients with coronary heart disease.Methods A total of 110 patients who underwent PCI in our hospital from January 2020 to December 2021 were randomly divided into home-based group with 56 patients and outpatient group with 54 patients.An individualized rehabilitation training prescription was formulated based on the results of CPET assessment,and the patients in the outpatient group received cardiac rehabilitation training at the outpatient service,while those in the home-based group received cardiac rehabilitation training at home.Related data were recorded before training and after 3 months of training,including cardiorespiratory exercise test results,7-item Generalized Anxiety Disorder Scale(GAD-7)score,and Patient Health Questionnaire-9(PHQ-9)score,and the changes in these indicators were compared between the two groups.Results After rehabilitation training,both groups had significant increases in anaerobic threshold power,anaerobic threshold metabolic equivalent(ATMets),anaerobic threshold oxygen uptake per kilogram(ATVO_(2)),peak power(PEAKPower),peak oxygen uptake per kilogram(PEAKVO_(2) max),and peak metabolic equivalent(PEAKMets)(t=2.22-6.43,P<0.05),with no significant changes in heart rate,systolic blood pressure,and diastolic blood pressure at resting state(P>0.05),and there were significant differences between the two groups in the changes in ATMets,ATVO_(2),PEAKPower,PEAKMets,and PEAKVO_(2) max after training(z=2.23-4.10,P<0.05).Both groups had significant reductions in GAD-7 and PHQ-9 scores after rehabilitation training(t=5.82-8.59,P<0.05),and there were no signi-ficant differences in the changes in GAD-7 and PHQ-9 scores between the two groups after training(P>0.05).Conclusion Both outpatient and home-based cardiac rehabilitation training can improve cardiopulmonary function and alleviat

关 键 词：冠心病 经皮冠状动脉介入治疗 运动试验 运动疗法 远程康复 抑郁 焦虑 中年人 青年人 

分 类 号：R541.4[医药卫生—心血管疾病] R654.33[医药卫生—内科学]