摘要
目的 探讨无氧阈强度运动治疗对血管重建后的慢性缺血性心脏病患者运动耐力的影响。方法43例完全血管重建后的慢性缺血性心脏病患者(3例冠脉搭桥,22例陈旧性心肌梗死及18例不稳定性心绞痛),实施了心肺运动负荷试验(CPET)和3个月的无氧阈强度的运动治疗,其中32例患者完成了运动治疗;3个月后复查CPET,比较患者运动耐力的前后变化。结果无氧阈运动强度心率[(97±9)次/min]显著小于传统运动康复的最小运动强度心率[(112±7)次/min],小于运动试验的最初缺血强度心率[(115±11)次/min];3个月后运动处方执行组无氧阈氧耗量从(10.7±2.4)ml·min^-1·b^-1到(12.6±2.9)ml-min^-1·b^-1(P=0.04),有氧运动负荷能力从(37±18)J/s到(47±13)J/s(P=0.04),峰值氧耗量从(15.3±3.1)ml·min^-1·kg^-1到(20.64-4.2)ml·min^-1·kg^-1(P=0.02)及峰值运动负荷能力(68±12)J/s到(87±14)J/s(P=0.01),均明显增加;运动处方未执行组的无氧阈氧耗量从(11.0±2.7)ml·min^-1·kg^-1到(11.3±2.8)ml·min^-1·kg^-1,有氧运动负荷能力从(38±11)J/s到(37±9)J/s,峰值氧耗量从(15.3±2.9)ml·min^-1·k^-1到(16.2±3.1)ml·min^-1·kg^-1]和峰值运动负荷能力从(65±13)J/s到(73±16)J/s增加,差异均无统计学意义。结论无氧阈强度显著小于慢性缺血性心脏病患者运动最初出现缺血时的强度;无氧阈强度运动治疗能有效地提高慢性缺血性心脏病患者的氧代谢水平和运动耐受力。
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 02 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 02 consumption (15.3±3.1 to 20.6 ±4.2 mlmin^-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 02 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 02 consumption (11.0±2.7 to 11.3±2.8 mlmin^-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 ischemie threshold post-CPET.Exercise therapy at the intensity of anaerobic threshold can improve oxygen capacity and exercise tolerance.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第24期1659-1662,共4页
National Medical Journal of China
基金
上海市市级医院新兴前沿技术联合攻关项目(SHDC12010117)
上海市重大科技攻关基金(05DZ19505)
上海市卫生局科技项目(2008082)
关键词
心肌缺血
运动试验
无氧阈
运动治疗
Myocardial ischemia
Exercise test
Anaerobic threshold
Exercise therapy