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[缺血性心脏病患者康复中对间歇性低氧-高氧的适应:运动耐力与生活质量]

[Adaptation to Intermittent Hypoxia-Hyperoxia in the Rehabilitation of Patients With Ischemic Heart Disease: Exercise Tolerance and Quality of Life].

作者信息

Syrkin A L, Glazachev O S, Kopylov F Y, Dudnik E N, Zagaynaya E E, Tuter D S

机构信息

I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

出版信息

Kardiologiia. 2017 May;57(5):10-16.

Abstract

AIM

to assess effect of interval hypoxic-hyperoxic training (IT) on exercise tolerance and quality of life of patients with ischemic heart disease (IHD) receiving optimal medical therapy, as well as the safety of IHHT use.

METHODS

Patients with stable IHD with functional class II and III angina (n=46) were randomized into two groups: IHHT (n=27, 15 treatments in 3 weeks), and IHHT imitation (n=19). Cardiopulmonary stress test was performed to evaluate the following parameters of exercise tolerance: peak oxygen consumption (VO2peak, VO2peak/kg), % of predicted peak oxygen consumption (%VO2 peak) and anaerobic threshold (VO2AT). MOS SF-36, SAQ, HADS questionnaires were used for assessment of quality of life (QL).

RESULTS

Exercise tolerance (VO2peak/kg) after course of IHHT significantly increased (p=0.03) and remained significantly elevated during subsequent month (p=0.036). Marked improvement was also observed in patients subjective perception of QL. This was evidenced by dynamics of characteristics of physical functioning as well as of psychological state, significant increase of values on all scales of disease-specific questionnaire SAQ, reduction of depression and anxiety according to dynamics of HADS scores. These effects persisted in 1 month after IHHT. IHHT was safe and well tolerated. Side effects were minimal (transient slight dizziness, feeling of shortage of air) and did not require IHHT termination.

CONCLUSION

We received clinical confirmation of safety and effectiveness in of IHHT in medically treated patients with stable angina. IHHT was associated with significant improvement of exercise tolerance, subjective perception of QL, reduction of number of angina attacks. Thus, IHHT has significant potential as component of complex treatment and rehabilitation of patients with stable angina.

摘要

目的

评估间歇性缺氧-高氧训练(IHHT)对接受最佳药物治疗的缺血性心脏病(IHD)患者运动耐力和生活质量的影响,以及IHHT使用的安全性。

方法

将患有II级和III级心绞痛的稳定型IHD患者(n = 46)随机分为两组:IHHT组(n = 27,3周内进行15次治疗)和IHHT模拟组(n = 19)。进行心肺应激试验以评估运动耐力的以下参数:峰值耗氧量(VO2peak,VO2peak/kg)、预测峰值耗氧量的百分比(%VO2 peak)和无氧阈值(VO2AT)。使用MOS SF-36、SAQ、HADS问卷评估生活质量(QL)。

结果

IHHT疗程后的运动耐力(VO2peak/kg)显著增加(p = 0.03),并在随后的一个月内保持显著升高(p = 0.036)。患者对QL的主观感受也有明显改善。这通过身体功能特征以及心理状态的动态变化得到证明,疾病特异性问卷SAQ所有量表上的值显著增加,根据HADS评分的动态变化,抑郁和焦虑有所减轻。这些效果在IHHT后1个月持续存在。IHHT是安全且耐受性良好的。副作用最小(短暂的轻微头晕、气短感),无需终止IHHT。

结论

我们获得了IHHT在药物治疗的稳定型心绞痛患者中安全性和有效性的临床证实。IHHT与运动耐力的显著改善、QL的主观感受、心绞痛发作次数的减少相关。因此,IHHT作为稳定型心绞痛患者综合治疗和康复的组成部分具有巨大潜力。

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