分阶段心脏康复训练联合有氧运动对冠心病合并2型糖尿病患者术后心肺功能和生存质量的影响

Effect of staged cardiac rehabilitation training combined with aerobic exercise on cardiopulmonary function and quality of life in patients with coronary heart disease complicated with type 2 diabetes mellitus

目的探讨分阶段心脏康复训练联合有氧运动对冠心病合并2型糖尿病患者术后心肺功能和生存质量的影响。方法选择2019年1月至2019年6月空军军医大学第一附属医院收治的400例冠心病合并2型糖尿病患者为研究对象,均行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)。依据随机数字表法将入选患者分为观察组与对照组,每组各200例。对照组患者术后行有氧运动干预,观察组患者在对照组基础上联合分阶段心脏康复训练干预。两组患者干预时间均为12周。比较两组患者干预前和干预后12周心功能、肺功能、运动能力和生存质量。结果两组患者干预后12周左室射血分数(left ventricular ejection fraction,LVEF)、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、最大自主通气量(maximal voluntary ventilation,MVV)、最大摄氧量(maximal oxygen uptake,VO_(2max))和最大运动负荷(maximum exercise load,MEL)均显著大于本组干预前(均P<0.05),左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)和左心室收缩末期内径(left ventricular end systolic diameter,LVESD)均显著小于本组干预前(均P<0.05),社会功能、生理功能、精神健康、一般健康状况、生理职能、躯体疼痛、精力和情感职能评分均显著高于本组干预前(均P<0.05)。观察组患者干预后12周LVEF、FEV1、MVV、VO_(2max)和MEL均显著大于对照组(均P<0.05),LVEDD和LVESD均显著小于对照组(均P<0.05),社会功能、生理功能、精神健康、一般健康状况、生理职能、躯体疼痛、精力和情感职能评分均显著高于对照组(均P<0.05)。结论分阶段心脏康复训练联合有氧运动可改善冠心病合并2型糖尿病患者PCI术后运动能力和心肺功能,且可提高患者生存质量。

Objective To investigate the effect of staged cardiac rehabilitation training combined with aerobic exercise on cardiopulmonary function and quality of life in patients with coronary heart disease complicated with type 2 diabetes mellitus.Method From January 2019 to June 2019,400 patients with coronary heart disease complicated with type 2 diabetes mellitus treated in the First Affiliated Hospital of Air Force Military Medical University were selected and treated by percutaneous coronary intervention(PCI).According to the random number table method,they were divided into observation group and control group,with 200 cases in each group.Control group patients received aerobic exercise intervention,while observation group patients received staged cardiac rehabilitation training intervention on the basis of control group.The intervention time of the two groups was 12 weeks.The heart function,lung function,exercise ability and quality of life were compared between the two groups before and 12 weeks after intervention.Result The left ventricular ejection fraction(LVEF),the forced expiratory volume in one second(FEV1)and maximal voluntary ventilation(MVV),maximal oxygen uptake(VO_(2max)),and maximum exercise load(MEL)in the two groups of patients 12 weeks after intervention were all significantly larger than those before intervention(all P<0.05),the left ventricular end diastolic dimension(LVEDD)and left ventricular end systolic diameter(LVESD)were significantly smaller than those before intervention(all P<0.05),the social functioning,physical functioning,mental health,general health,role physical,bodily pain,vitality and role emotional were significantly higher than those before intervention(all P<0.05).At 12 weeks after intervention,the LVEF,FEV1,MVV,VO_(2max)and MEL in observation group were signi ficantly larger than those in control group(all P<0.05),the LVEDD and LVESD in observation group were significantly smaller than those in control group(all P<0.05),the social functioning,physical function,mental health,general health,role physical,bodily pain,vitality and emotional functioning of patients in observation group were significantly higher than those in control group(all P<0.05).Conclusion Staged cardiac rehabilitation training combined with aerobic exercise can improve the exer cise ability and cardiopulmonary function of patients with coronary heart disease complicated with type 2 diabetes mellitus after PCI,and can improve the quality of life of patients.