心脏运动康复对PCI术后冠心病患者心肺功能及生活质量的影响
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摘要
目的评价心脏运动康复对冠心病经皮冠状动脉介入治疗(PCI)术后患者心肺功能及生活质量的影响。方法入选确诊并已行PCI出院的冠心病患者110例,按个人意愿分为康复组和对照组各55例,收集患者的一般资料、入选时和运动治疗6月后心肺运动试验、心脏超声的相关指标及西雅图心绞痛量表(SAQ)等数据,并进行统计学分析,评估心脏运动康复对冠心病PCI术后患者心肺功能及生活质量的影响。结果 6个月运动康复治疗后,康复组患者无氧阈(AT)、最大摄氧量(VO2max)、氧脉搏(O2pulse)、最大运动时间、左心室射血分数(LVEF)、SAQ评分均优于干预前与对照组,差异有统计学意义(P<0. 05)。结论心脏运动康复治疗可以改善冠心病PCI术后患者的心肺功能,提高患者的运动耐力及生活质量,是冠心病PCI术后患者二级预防的重要组成部分。
Aim To explore the effects of cardiac exercise rehabilitation on cardiopulmonary function and quality of life in patients with coronary heart disease after percutaneous coronary intervention( PCI). Methods 110 patients with coronary heart disease who were diagnosed and had undergone PCI were randomly divided into the rehabilitation group and the control group,according to the order of treatment and personal wishes,55 cases in each group. General data of patients,cardiopulmonary exercise test after 6 months of exercise,cardiac ultrasound related indicators and Seattle angina scale( SAQ) were collected,and statistical analysis was performed to assess the effects of cardiac exercise rehabilitation on cardiopulmonary function and quality of life in patients with coronary heart disease after PCI. Results After 6 months exercise rehabilitation treatment,the anaerobic threshold( AT),maximal oxygen uptake( VO2 max),oxygen pulse( O2 pulse),maximal exercise time,left ventricular ejection fraction( LVEF) and SAQ score in the rehabilitation group were significantly higher than before intervention and control group( P<0. 05). Conclusions Cardiac exercise rehabilitation therapy can improve cardiopulmonary function,exercise endurance and quality of life in patients with coronary heart disease after percutaneous coronary intervention. It is an important part of secondary prevention in patients with coronary artery disease after percutaneous coronary intervention.
Aim To explore the effects of cardiac exercise rehabilitation on cardiopulmonary function and quality of life in patients with coronary heart disease after percutaneous coronary intervention( PCI). Methods 110 patients with coronary heart disease who were diagnosed and had undergone PCI were randomly divided into the rehabilitation group and the control group,according to the order of treatment and personal wishes,55 cases in each group. General data of patients,cardiopulmonary exercise test after 6 months of exercise,cardiac ultrasound related indicators and Seattle angina scale( SAQ) were collected,and statistical analysis was performed to assess the effects of cardiac exercise rehabilitation on cardiopulmonary function and quality of life in patients with coronary heart disease after PCI. Results After 6 months exercise rehabilitation treatment,the anaerobic threshold( AT),maximal oxygen uptake( VO2 max),oxygen pulse( O2 pulse),maximal exercise time,left ventricular ejection fraction( LVEF) and SAQ score in the rehabilitation group were significantly higher than before intervention and control group( P<0. 05). Conclusions Cardiac exercise rehabilitation therapy can improve cardiopulmonary function,exercise endurance and quality of life in patients with coronary heart disease after percutaneous coronary intervention. It is an important part of secondary prevention in patients with coronary artery disease after percutaneous coronary intervention.
引文
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[6]中华医学会心血管病学分会介入心脏病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志,2016,44(5):382-400.
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[9]许艳梅,冯玉宝,苏平,等.运动康复对经皮冠状动脉介入治疗术后冠心病患者心功能的影响[J].中国循环杂志,2017,32(4):326-330.
[10]白瑾,张永珍.心肌梗死心脏康复的循证医学证据[J].中国医学前沿杂志,2013(9):8-10.
[11]马跃文,刘畅.心脏康复对于冠心病患者抑郁、焦虑情绪改善的研究进展[J].中国康复理论与实践,2012,18:141-143.
[12]Pisano GMM,González PA. Modifying habits and treatment adherence,essential for controlling the chronic disease[J]. Enferm Clin,2014,24(1):59-66.
[13]唐莲,刘春雪,李泱,等.中老年冠心病患者行冠状动脉介入术后心脏康复认知度与运动依从性相关的调查研究[J].中华老年多器官疾病杂志,2018,17(1):66-69.
[14]朱青. PCI术后患者危险因素控制情况调查和心脏康复干预效果研究[D].长沙:湖南师范大学,2015:1-58.
[15]Munk PS,Breland UM,Aukrust P,et al. High intensity interval training reduces systemic inflammation in post-pci patients[J].Eur J Cardiovasc Prev Rehabil,2011,18(6):850-857.
[2]陈纪言,陈韵岱,韩雅玲,等.经皮冠状动脉介入治疗术后运动康复专家共识[J].中国介入心脏病学杂志,2016,24(7):361-369.
[3]中华医学会心血管病学分会预防学组,中国康复医学会心血管病专业委员会.冠心病患者运动治疗中国专家共识[J].中华心血管病杂志,2015,43(7):575-588.
[4]Perk J,Backer GD,Gohlke H,et al. European guidelines on cardiovascular disease prevention in clinical practice(version 2012):the fifth joint task force of the european society of cardiology and other societies on cardiovascular disease prevention in clinical practice(constituted by representatives of nine societies and by invited experts)[J]. Eur J Prev Cardiol,2012,19(4):585-667.
[5]Levine GN,Bates ER,Blankenship JC,et al. 2011 ACCF/AHA/SCAI Guideline for percutaneous coronary intervention:executive summary:areport of theamerican college of cardiology foundation/american heart association task force on practice guidelines and the society forcardiovascular angiography and interventions[J]. Circulation,2011,124(23):2574-2609.
[6]中华医学会心血管病学分会介入心脏病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志,2016,44(5):382-400.
[7]赵焕,王连生.运动对冠心病影响的研究进展[J].心血管病学进展,2012,33(2):203-206.
[8]Acar RD,Bulut M,ErgünS,et al. Effect of cardiac rehabilitation on left atrial functions in patients with acute myocardial infarction[J]. Ann Phys Rehabil Med,2014,57(2):105-113.
[9]许艳梅,冯玉宝,苏平,等.运动康复对经皮冠状动脉介入治疗术后冠心病患者心功能的影响[J].中国循环杂志,2017,32(4):326-330.
[10]白瑾,张永珍.心肌梗死心脏康复的循证医学证据[J].中国医学前沿杂志,2013(9):8-10.
[11]马跃文,刘畅.心脏康复对于冠心病患者抑郁、焦虑情绪改善的研究进展[J].中国康复理论与实践,2012,18:141-143.
[12]Pisano GMM,González PA. Modifying habits and treatment adherence,essential for controlling the chronic disease[J]. Enferm Clin,2014,24(1):59-66.
[13]唐莲,刘春雪,李泱,等.中老年冠心病患者行冠状动脉介入术后心脏康复认知度与运动依从性相关的调查研究[J].中华老年多器官疾病杂志,2018,17(1):66-69.
[14]朱青. PCI术后患者危险因素控制情况调查和心脏康复干预效果研究[D].长沙:湖南师范大学,2015:1-58.
[15]Munk PS,Breland UM,Aukrust P,et al. High intensity interval training reduces systemic inflammation in post-pci patients[J].Eur J Cardiovasc Prev Rehabil,2011,18(6):850-857.