运动心脏康复治疗对冠心病冠脉重建术后患者血管内皮功能的影响

Effects of exercise training on rasacular endothelium function in patients with coronary artery disease after CABG/PTCA

目的 :观察康复运动治疗对冠心病患者冠脉重建术后内皮素、一氧化氮的浓度以进一步探讨运动治疗对冠心病患者内皮功能的作用。方法 :选择 66例均经皮冠状动脉成形术后 (PTCA)和 /或冠状动脉搭桥术后 (CABG)患者 ,按随机原则进入康复运动治疗组和常规治疗组 (各 3 3例 ) ,两组患者均有常规用药且两组用药情况无差异 ,康复运动治疗组除常规治疗外 ,还要接受按运动处方规定的 12周的康复运动治疗 ,康复运动治疗方案按Ⅱ期运动方案制定 ,从最大运动量的 65 %开始 ,逐渐增加到 80 % ,常规治疗组无康复运动治疗。结果 :康复运动治疗组 12周疗程前、后以及两组疗程后的血管充血引起的肱动脉的内径的变化均有显著性差异 (P <0 .0 1) ,而常规治疗组疗程前、后血管充血引起的肱动脉的内径的变化无显著性差异 (P >0 .0 5 )。结论 :冠脉重建术后冠心病患者经过 12周康复运动治疗后肱动脉内径反应性血管充血功能明显改善 。

Objective:To investigate the effect of exercise training on artery endothelium function of patients, and address the relationship between cardiac rehabilitation exercise training and cardiovascular endothelial function.Method:66 patients diagnosed as coronary artery disease(CAD) after PTCA/CABG were enrolled . They were randomly divided into rehabilitation exercise training group and conventional care group. The patients in exercise training group got 12 weeks of exercise training and conventional care.The exercise program provided supervised conditioning for patients in rehabilitation department Guangdong Cardiovascular Institute. Exercise prescription was dependent on Phase Ⅱ.The conventional group only had conventional care. Result: Flow-mediated dilatation(FMD) increased significantly after the training program in the CR exercise group, but conventional group had no change( P <0.01). Conclusion:The change in FMD was only related to exercise training, and was independent of changes in baseline vessel size. The research indicated the rehabilitive exercise training can improve endothelium function in patients with CAD.