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[运动疗法对慢性稳定性冠心病患者运动耐力的无氧阈强度影响]

[Effects of exercise therapy at the intensity of anaerobic threshold for exercise tolerance in patients with chronic stable coronary artery disease].

作者信息

Che Lin, Gong Zhu, Jiang Jin-fa, Xu Wen-jun, Deng Bing, Xu Jia-hong, Yan Wen-wen, Zhang Qi-ping, Wang Le-min

机构信息

Department of Cardiology, Tongji University School of Medicine, Shanghai 200065, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2011 Jun 28;91(24):1659-62.

Abstract

OBJECTIVE

To investigate the effects of exercise therapy at the intensity of anaerobic threshold (AT) for exercise tolerance in patients with chronic stable coronary artery disease.

METHODS

Forty-three patients with chronic stable coronary artery disease (3 patients after coronary arterial bypass graft (CABG) surgery, 22 patients with old myocardial infarction and 18 unstable angina pectoris undergoing successful percutaneous coronary intervention (PCI) finished twice cardiopulmonary exercise test (CPET) and followed their rehabilitation program for 3 months. Thirty-two patients finished their aerobic exercise therapy based on their individual anaerobic thresholds while 11 patients had no exercise therapy.

RESULTS

The heart rate at AT intensity (97 ± 9/min) was lower than their traditional minimal target heart rate (112 ± 7/min) and lower than heart rate (115 ± 11/min) at ischemic threshold post-CPET. The O(2) consumption (10.7 ± 2.4 to 12.6 ± 2.9 ml×min(-1)×kg(-1)) (P = 0.04) and workload (37 ± 18 to 47 ± 13 J/s) (P = 0.04) at AT level and the O(2) consumption (15.3 ± 3.1 to 20.6 ± 4.2 ml×min(-1)×kg(-1), P = 0.02) and workload(68 ± 12 and 87 ± 14 J/s, P = 0.01) at peak level markedly increased after 3 months in the exercise group. And the O(2) consumption (15.3 ± 2.9 to 16.2 ± 3.1 ml×min(-1)×kg(-1)) and workload (65 ± 13 to 73 ± 16 J/s) at peak level mild increased after 3 months in the non-exercise group, but their O(2) consumption (11.0 ± 2.7 to 11.3 ± 2.8 ml×min(-1)×kg(-1)) and workload (38 ± 11 to 37 ± 9 J/s) at AT level had no obvious change.

CONCLUSION

AT exercise intensity was lower than ischemic threshold post-CPET. Exercise therapy at the intensity of anaerobic threshold can improve oxygen capacity and exercise tolerance.

摘要

目的

探讨无氧阈(AT)强度的运动疗法对慢性稳定型冠心病患者运动耐力的影响。

方法

43例慢性稳定型冠心病患者(3例行冠状动脉旁路移植术(CABG)后患者、22例陈旧性心肌梗死患者和18例成功接受经皮冠状动脉介入治疗(PCI)的不稳定型心绞痛患者)完成两次心肺运动试验(CPET),并进行3个月的康复计划。32例患者根据各自的无氧阈完成有氧运动疗法,11例患者未进行运动疗法。

结果

运动组患者在AT强度时的心率(97±9次/分钟)低于其传统的最低目标心率(112±7次/分钟),且低于CPET后缺血阈时的心率(115±11次/分钟)。运动组患者在3个月后,AT水平时的耗氧量(从10.7±2.4增至12.6±2.9毫升·分钟⁻¹·千克⁻¹)(P = 0.04)和工作量(从37±18增至47±13焦/秒)(P = 0.04)以及峰值水平时的耗氧量(从15.3±3.1增至20.6±4.2毫升·分钟⁻¹·千克⁻¹,P = 0.02)和工作量(从68±12增至87±14焦/秒,P = 0.01)均显著增加。非运动组患者在3个月后峰值水平时的耗氧量(从15.3±2.9增至16.2±3.1毫升·分钟⁻¹·千克⁻¹)和工作量(从65±13增至73±16焦/秒)轻度增加,但其AT水平时的耗氧量(从11.0±2.7增至11.3±2.8毫升·分钟⁻¹·千克⁻¹)和工作量(从38±11降至37±9焦/秒)无明显变化。

结论

AT运动强度低于CPET后的缺血阈。无氧阈强度的运动疗法可提高氧摄取能力和运动耐力。

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