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以个性化运动训练为核心的心脏康复方案对冠心病经皮冠状动脉介入治疗术后患者整体功能进一步改善的影响

[Effects of cardiac rehabilitation protocol centered with personalized - exercise training on further improvement of holistic function in patients with coronary heart disease after percutaneous coronary intervention].

作者信息

Zhang Zhen-Ying, Sun Xing-Guo, Sun Xiao-Jing, Feng Jing, Xi Jia-Ning, Yu Hong, Tai Wen-Qi, Liu Fang, Zhang Ye, Liu Yan-Ling, Wang Li-Zhong

机构信息

Cardiac Rehabilitation Center,Beijing Rehabilitation Hospital of Capital Medical University, Beijing 100144.

National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease Clinical Medicine Research, Beijing 100037, China.

出版信息

Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2021 Mar;37(2):202-207. doi: 10.12047/j.cjap.0097.2021.125.

DOI:10.12047/j.cjap.0097.2021.125
PMID:34672159
Abstract

To investigate the effects of cardiac rehabilitation protocol centered with personalized - exercise training (ET) on further improvement of holistic function in patients with stable angina after percutaneous coronary intervention (PCI). 20 patients who were diagnosed with stable angina in Beijing Rehabilitation Hospital from June 2016 to December 2019, were randomly divided into control group (n=10) and ET group (n=10). All patients were received PCI selectively. After PCI, patients in Control group were treated with conventional cardiac rehabilitation without ET; patients in ET group were treated with ET-based cardiac rehabilitation for 12 weeks. Cardiopulmonary exercise testing (CPET) parameters, echocardiogram and 6-minute walking distance (6MWD) of 2 groups of patients were recorded respectively before PCI, 2 weeks after PCI and 12 weeks after ET. All patients in 2 groups finished symptom limited maximum CPET, and patients in ET group finished 12 weeks - ET safely without complications. Before PCI and 2 weeks after PCI, there were no differences in parameters including anaerobic threshold (AT), peak oxygen uptake, peak oxygen pulse, left ventricular ejection fraction (LVEF) and 6MWD between control group and ET group(P>0.05); after 12-week treatment, AT(ml/min,ml/(min·kg)), peak oxygen uptake(ml/(min·kg)), peak oxygen pulse(ml/beat) and 6MWD of patients in ET group were higher significantly than those of patients in control group (P<0.05). In ET group, the variables including AT (ml/min、ml/(min·kg)、%pred), peak oxygen uptake(ml/min,ml/(min·kg),%pred), peak oxygen pulse (ml/beat) and 6MWD of patients after 12-week ET were significantly higher than those of patients before PCI treatment (P<0.05); notably, AT (ml/(min·kg)) and peak oxygen uptake (ml/(min·kg)) of patients in ET group were significantly higher after 12-week ET program compared with those of patients 2 weeks after PCI ( P<0.05). In Control group, AT(ml/min)and peak oxygen pulse(ml/beat)of patients after 12-week treatment were higher than those of patients before PCI ( P<0.05), but there were no difference between 2 weeks after PCI and 12-week treatment ( P>0.05). Personalized - exercise training after PCI could further improve the cardiac function and exercise endurance, ET - based cardiac rehabilitation is an important part of secondary prevention for patients after PCI, which needs to be widely promoted.

摘要

探讨以个性化运动训练(ET)为核心的心脏康复方案对经皮冠状动脉介入治疗(PCI)后稳定型心绞痛患者整体功能进一步改善的影响。选取2016年6月至2019年12月在北京康复医院确诊为稳定型心绞痛的患者,随机分为对照组(n = 10)和ET组(n = 10)。所有患者均选择性接受PCI治疗。PCI术后,对照组患者接受不包含ET的传统心脏康复治疗;ET组患者接受为期12周的以ET为基础的心脏康复治疗。分别记录两组患者在PCI术前、PCI术后2周以及ET治疗12周后的心肺运动试验(CPET)参数、超声心动图及6分钟步行距离(6MWD)。两组所有患者均完成症状限制的最大CPET,ET组患者安全完成12周的ET治疗,无并发症发生。PCI术前及术后2周,对照组和ET组在无氧阈(AT)、峰值摄氧量、峰值氧脉搏、左心室射血分数(LVEF)及6MWD等参数方面无差异(P>0.05);治疗12周后,ET组患者的AT(ml/min,ml/(min·kg))、峰值摄氧量(ml/(min·kg))、峰值氧脉搏(ml/beat)及6MWD显著高于对照组(P<0.05)。在ET组,患者经过12周ET治疗后的AT(ml/min、ml/(min·kg)、%pred)、峰值摄氧量(ml/min,ml/(min·kg),%pred)、峰值氧脉搏(ml/beat)及6MWD显著高于PCI治疗前(P<0.05);值得注意的是,与PCI术后2周相比,ET组患者在经过12周ET治疗后的AT(ml/(min·kg))及峰值摄氧量(ml/(min·kg))显著升高(P<0.05)。在对照组,治疗12周后的患者AT(ml/min)及峰值氧脉搏(ml/beat)高于PCI术前(P<0.05),但PCI术后2周与治疗12周之间无差异(P>0.05)。PCI术后的个性化运动训练可进一步改善心脏功能和运动耐力,以ET为基础的心脏康复是PCI术后患者二级预防的重要组成部分,需要广泛推广。

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