冠心病患者术后运动能力及影响因素的调查研究

Retrospective analysis of exercise capacity in patients with coronary artery disease after percutaneous coronary intervention or coronary artery bypass graft

目的了解冠心病术后患者接受经皮冠状动脉介入治疗或冠状动脉搭桥术后运动能力,并分析其影响因素.方法采用回顾性调查,对2019年1-10月在医院心脏康复中心就诊的230例冠心病术后患者的病历资料进行分析.采用心肺运动试验测量患者的运动能力,采用Zung焦虑自评量表和Zung抑郁自评量表分别测量患者的焦虑和抑郁情绪.采用卡方检验、Fisher精确检验、t检验、Mann-Whitney U检验和多元logistic回归分析方法进行统计学分析.结果在230例冠心病术后患者中,223例存在运动能力降低的情况.多元lo-gistic回归分析结果显示,焦虑(OR=1.13,95%CI:1.01~1.32,P=0.029)与冠心病术后患者运动能力降低有关.结论冠心病术后患者的运动能力较差,医护人员对患者进行干预时应考虑减轻其焦虑,根据心肺运动试验结果制订个性化运动处方,以提高患者的运动能力.

Objectives:To describe the current state of exercise capacity as well as to identify its predictors in patients with coronary artery disease (CAD) following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in the mainland of China.Methods:A retrospective study design was employed.We evaluated 230 CAD patients following PCI or CABG in a cardiac rehabilitation center from January 2019 to October 2019.The patients were referred to undergo incremental cardiopulmonary exercise testing with a cycle ergometer.The Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale were used to evaluate patients' mental health.Statistical analysis was performed using the chi-square test,Fisher's exact test,t-test,Mann-Whitney U test,and binary logistic regression.Results:Among the 230 patients,223 patients demonstrated reduced exercise capacity.Resutlts of the logistic regression analysis showed that anxiety (OR =1.13,95% CI 1.01-1.32,P =0.029) was an independent risk factor for reduced exercise capacity in patients following the PCI or CABG.Conclusions:Exercise capacity of Chinese CAD patients after PCI or CABG was relatively poor.Alleviating symptoms of anxiety and making exercise prescriptions according to the results of the cardiopulmonary exercise test should be considered during the intervention to improve CAD patients' exercise capacity.