康复运动疗法对冠脉成形术后侧枝循环及再狭窄的影响

Effects of rehabilitation exercise protocol on restenosis and collateral circulation in patients with coronary heart disease following percutaneous transluminal coronary angioplasty

目的 :探讨康复运动疗法对冠心病患者冠脉成形术 (PTCA)后侧枝循环和再狭窄的影响。方法 :选择 43例接受PTCA术患者 ,其中 2 5例 (A组 )进行三阶段康复运动治疗 ,1 8例 (B组 )在此基础上同时采用体外反搏康复治疗。 3个月后均采用了Bruce方案亚极量分级运动试验进行康复评定。同时行冠脉造影术判定侧枝循环和再狭窄情况。结果 :A、B两组患者的康复训练进展均较快 ,其中第三阶段RPP和RPE值B组明显低于A组 (P <0 0 5) ;运动试验评定中 ,A、B两组均达较高康复水平 ;METs、RPP、RPE等指标显著优于对照组 ;A、B两组狭窄发生率分别为 1 2 %和 5 5 % ,均显著低于对照组的 33 3 % (P <0 0 5和P <0 0 1 ) ,B组侧枝循环记分均高于对照组 ,而A、B组间无显著差异。结论 :PTCA术后有效的康复运动疗法可降低了再狭窄发生率 ,改善了冠脉侧枝循环 。

Objective:To study effects of rehabilitation exercises on restenosis and collateral circulation in patients with coronary heart disease following percutaneous transluminal coronary angioplasty(PTCA).Method:Rehabilitation exercise training was applied in 43 patients with coronary heart disease(CHD) following PTCA,in which 25 cases(group A) received three advancing stages program(TSP) and 18 cases(group B) received both extracorparal counterpulsation and TSP,submaximal graded exercise testing was adopted for evaluation of rehabilitation,while the coronary angiography was used to judge restenosis and collateral circulation situation.Result:The progress of exercise training were rapid in group A and B.RPP and RPE of group B in the third stage were lower than that of group A( P <0.05).The function capacities of group A and B reached a higher level at the third month after discharge.The restenosis rates of group A and B at the sixth month were significantly lower(5.5% and 12%,respectively) than that of the control group(33.3%)( P <0.01 and P <0.05).The score of colleteral circulation in A,B group were higher than that of the control group( P <0.01).Conclusion:Rehabilitation exercise training benefits the patients following PTCA through decreasing restenosis rate and ameliorating the collateral circulation,the heart function capacity and quality of life are enhanced accordingly.