心脏康复分级运动对老年冠心病合并肺动脉高压患者心功能的影响及预后研究

Effect of cardiac rehabilitation graded exercise on cardiac function and prognosis in elderly patients with coronary heart disease complicated with pulmonary hypertension

目的探究心脏康复分级运动对老年冠心病合并肺动脉高压患者心功能的影响及累积死亡率比较。方法分析2015年1月—2016年6月在我院接受治疗的57例老年冠心病合并肺动脉高压患者的临床资料,对照组患者31例,采用常规方法进行治疗,观察组26例,在对照组治疗基础上辅助以心脏康复分级运动方案。结果观察组患者治疗后HR、LVEF明显高于对照组(P<0.05),观察组患者治疗后LVEDD、PASP及心功能分级水平低于对照组(P<0.05);观察组患者METS、6min步行距离及Barthel评分明显高于对照组(P<0.05);经Log-rank检验发现,观察组患者累积死亡率明显低于对照组,差异具有统计学意义(3/26,11.54%vs 9/31,29.03%,Log-rankχ^2=4.853,P=0.028)。结论心脏康复分级运动联合药物可以明显冠心病合并肺动脉高压患者改善患者的心功能及临床症状,提高患者的自理生活能力,降低死亡风险。

Objective:To investigate effects of cardiac rehabilitation exercise on cardiac function in elderly patients with coronary heart disease complicated with pulmonary hypertension and comparison of cumulative mortality.Methods:Analyzing 57 cases clinical data of CHD patients with pulmonary hypertension from January 2013 to June 2014 in our hospital,Patients in the control group(31 cases),using conventional methods of treatment,the observation group(n=26)were treated in cardiac rehabilitation graded exercise program based on the control group.Results:After treatment,LVEF,HR in observation group was significantly higher than the control group(P<0.05),PASP,LVEDD and cardiac function classification level in the observation group was lower than the control group(P<0.05);METS,6min walking distance and Barthel score in observation group was significantly higher than the control group(P<0.05).By Log-rank test,we found that the cumulative mortality of the observation group was significantly lower than that of the control group,the difference was statistically significant(3/26,11.54%vs 9/31,29.03%,Log-rankχ^2=4.853,P=0.028).Conclusions:Cardiac rehabilitation combined with drugs can significantly improve the cardiac function and clinical symptoms in patients with coronary heart disease combined with pulmonary hypertension,improve their self-care ability and reduce the risk of death.