心脏康复锻炼对冠心病合并睡眠障碍患者自主神经功能的影响

Effects of Rehabilitation Therapy on Autonomic Nervous Function of Patients with Coronary Heart Disease Combined with Sleep Disorder

目的分析心脏康复锻炼对冠心病合并睡眠障碍患者的自主神经功能的影响,探讨运动与冠心病患者睡眠状态及自主神经功能稳定性的关系。方法随机选取经冠状动脉造影确诊为冠心病且PSQI评分大于7分的患者80例,按入院先后顺序分成康复运动组及药物治疗组各40例,另选取冠脉造影结果正常者40例为对照组,记录患者入院后心率变异性(heart rate variability,HRV)及PSQI评分。康复运动组给予冠心病药物治疗及心脏康复运动治疗12周;药物治疗组给予冠心病药物治疗及心理暗示12周,必要时给予睡眠药物治疗;对照组不给予康复锻炼及药物治疗。治疗结束后再次对康复运动组和对照组行HRV及PSQI评分检测。结果治疗前康复运动组和药物治疗组与对照组比较HRV较低,PSQI评分较高(P<0.05);治疗结束后康复运动组PSQI评分降低,HRV指标升高,与康复治疗前比较差异有统计学意义(P<0.05);药物治疗组治疗前后HRV及PSQI评分比较差异无统计学意义(P>0.05)。结论冠心病合并睡眠紊乱患者存在自主神经紊乱,心脏康复运动可改善冠心病患者自主神经功能及睡眠质量。

Objective To analyze the effects of cardiac rehabilitation exercise on the autonomic nervous function in patients with coronary heart disease combined with sleep disorders,and to discuss the correlation between exercise and sleep stability as well as autonomic nerve stability. Methods 80 patients with coronary heart disease confirmed by coronary angiography and with PSQI score more than 7 points were randomly divided into the rehabilitation group and the drug treatment group with 40 cases in each group,according to the order of admission.40 patients with coronary angiography were selected into the control group.Heart rate variability（HRV）index and PSQI score were recorded.Patients in the rehabilitation exercise group received coronary heart disease medication and cardiac rehabilitation exercise for 12 weeks.Patients in the drug treatment group were given coronary heart disease drugs and psychological suggestion for 12 weeks,and they were given sleep medication when it was necessary.Patients in the control group were not given rehabilitation exercise and medication.After treatment, HRV and PSQI score in the rehabilitation exercise group and the control group were detected again. Results Before treatment,HRV of hehabilitation group and drug treatment group was lower and PSQI score was higher compared with the control group （P 〈0.05）.PSQI score of the rehabilitation group after treatment was lower than that before treatment,and HRV was higher,the difference was statistically significant （P 〈0.05）.There was no statistically significant difference between HRV and PSQI score in the control group before and after treatment （P 〉0.05）. Conclusion There were autonomic nervous disorders in patients with coronary heart disease complicated with sleep disorder,and cardiac rehabilitation exercise could improve the autonomic nervous function and sleep quality of patients with coronary heart disease.