门诊运动训练和居家运动训练对经皮冠状动脉介入治疗术后中低危患者运动耐量影响研究

Effect of outpatient exercise and home exercise training the tolerance of patients at moderate or low risk after interventional therapy

目的探讨门诊运动和居家运动对经皮冠状动脉介入治疗(PCI)术后患者危险因素及运动耐量的影响。方法选取2015年11月至2016年9月中国医科大学附属盛京医院收治的冠心病接受PCI治疗并成功的患者43例。将43例患者随机分为门诊运动康复组(22例)和居家运动康复组(21例)。两组患者均给予冠心病二级预防常规治疗并制定个体化运动处方,规律完成3个月运动康复治疗。门诊组在门诊完成;居家组在院外完成。比较康复前后患者部分危险因素、运动耐量的变化,比较两组患者运动效果的差异。结果门诊组及居家组患者的一般状况及运动前首次运动心肺功能测试的各项指标在两组间差异均无统计学意义。运动康复后,患者体重指数、心率、收缩压、血脂及运动耐量等均有明显改善(P<0.05);院内康复组运动耐量的提升与居家治疗组比较差异无统计学意义(P>0.05)。结论运动康复治疗可改善冠状动脉支架植入术后低中危冠心病患者的运动耐量,是PCI术后一种安全、有效、依从性高的心脏康复治疗模式。对于低中危的PCI术后患者居家运动康复模式更便于推广。

Objective To systematically examine the effects of clinic-based and home-based exercise training on risk factors and exercise tolerance in individuals after percutaneous coronary intervention. Methods Fourty three patients with coronary heart disease who underwent PCI in Shengiing Hospital of China Medical University from Nov.2015 to Sep.2016 were selected then randomly divided into clinic-based exercise training group （n = 22） and home-based exercise training group （n = 21）. Both group were given routine treatment of secondary prevention and tailored exercise prescription before 3 months of exercise rehabilitation. Clinic-based did it in clinic while home-based in their own home. Both groups＇ risk factors and exercise tolerance were assessed after the exercise training. Result Risk factors including body mass index, heart rate, systolic blood pressure, lipids and exercise tolerance have significantly improved after the exercise training in the both groups（P〈0.05）, while there is no significant differences in the improvement of exercise tolerance between clinic-based group and home-based group（P 〉0.05）. Conclntion Exercise training can improve the exercise tolerance of post PCI patients. It is a safe, effective and compliant rehabilitation model for low-to-moderate post PCI patients and home-based exercise training is more suitable for them.