摘要
目的探讨经皮冠状动脉介入治疗后的急性冠脉综合征患者选择不同的运动康复方式对疗效的影响。方法选取自2015年4月至2016年10月于沈阳军区总院行经皮冠状动脉介入治疗后,且愿意接受和坚持运动治疗的33例急性冠脉综合征患者为研究对象,根据患者意愿分为单次运动指导后家庭运动康复组(A组,n=18)与院内长期指导运动康复组(B组,n=15)。有氧运动方案选择功率自行车,每周3～5次,每次20～40 min,运动强度为无氧阈对应心率。运动康复前后行症状限制性心肺运动试验,比较各组患者治疗前后心肺运动试验相关指标以评估疗效。结果全部患者成随访,中位数随访时间212 d,无心血管不良事件发生。患者的峰值公斤摄氧量平均提高达34. 8%,其中,B组提高更明显,达54. 3%。运动治疗后,A组最大通气量(%)较治疗前明显提高,差异有统计学意义(P <0. 05)。运动治疗后,B组峰值公斤摄氧量、峰值负荷及最大通气量(%)较治疗前明显提高,差异有统计学意义(P <0. 05)。结论运动康复可改善经皮冠状动脉介入后急性冠脉综合征患者的运动耐力,鼓励患者进行医师指导下的运动康复,以更好地提高依从性及疗效。
Objective To investigate the curative effect of different modes of exercise rehabilitation among patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI).Methods A retrospective study was performed on 33 cases of ACS patients underwent PCI and accepted exercising treatment from April 2015 to October 2016.According to the will of exercise,patients were divided into the self-exerciser habilitation group(Group A,n=18)and exercise rehabilitation under physician direction group(Group B,n=15).The training program was 20 to 40 minutes of aerobic exercise on a treadmill and exercise bike 3 to 5 times per week at least 3 months.The exercise intensity was based on the heart rate corresponding to anaerobic threshold.A symptom limited cardiopulmonary exercise testing(CPET)was performed pre-and post-exercise to compare the efficacy of different modes.Results All patients were followed up,with a median follow-up time of 212 days,and no cardiovascular adverse events occurred.The mean increase of VO 2 peak/kg uptake was 34.8%,and the increase was more obvious in Group B,which was 54.3%.After exercise treatment,the maximum gas volume(MVV%)in Group A was significantly higher than that before treatment(P<0.05).After exercise treatment,the VO 2 peak/kg uptake,MVV%in Group B were significantly higher than those before treatment,and the difference was statistically significant(P<0.05).Conclusion Exercise rehabilitation could increase exercise tolerance in patients with ACS undergoing PCI.Supervised exercise rehabilitation might improve the prognosis of patients more significantly and should be recommended.Key words:
作者
孙毅
张剑
梁延春
李毅
张权宇
张伊
贺婧斐
韩雅玲
SUN Yi;ZHANG Jian;LIANG Yan-chun;LI Yi;ZHANG Quan-yu;ZHANG Yi;HE Jing-fei;HAN Ya-ling(Department of Cardiology,Cardiovascular Research Institute of PLA,The General Hospital of Shenyang Military Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2018年第10期1156-1159,共4页
Clinical Journal of Medical Officers
基金
中国工程院院士咨询项目(2017-XY-33)
关键词
急性冠脉综合征
经皮冠状动脉介入治疗
运动康复
心肺运动试验
疗效
Acute coronary syndrome
Percutaneous coronary intervention
Exercise rehabilitation
Cardiopulmonary exercise testing
Efficacy
