高强度间歇运动在冠心病患者中的应用

Application of high-intensity interval exercise in patients with coronary heart disease

目前,心脏康复作为冠心病的二级预防已逐渐在临床中应用,它能够有效改善冠心病患者的预后和转归。运动康复是心脏康复的重要组成部分,可以提高冠心病患者的心肺功能和运动耐力,从而提高患者的生活质量,改善患者的预后。其中,高强度间歇运动(high-intensity interval training,HIIT)相比较于其他运动方式在改善患者心肺功能、血管内皮功能、生活质量等方面具有一定的优越性。但因其运动强度较高,心脏康复医师对其运动安全性等方面仍存在疑虑,这些因素制约了其在心脏康复中的应用。本综述分别对HIIT的定义、HIIT的适应症及禁忌症、HIIT在心肺功能与化验指标中的作用、对冠心病患者血管内皮功能以及生活质量的影响进行阐述,并对HIIT联合药物治疗的效果进行了归纳,从而为临床及运动康复策略研究提供新的思路和方向。

At present,cardiac rehabilitation as secondary prevention of coronary heart disease has been gradually applied in clinical practice,which can effectively improve the prognosis and outcome of patients with coronary heart disease(CHD).Exercises play an important part in cardiac rehabilitation,which can improve the cardiopulmonary functions and the exercise endurance of patients with coronary heart disease,thus improving the quality of life and the prognosis of patients.High-intensity interval training(HIIT)has a certain degree of superiority in improving cardiopulmonary functions,vascular endothelial functions and the quality of life compared with other kinds of exercises.However,some cardiac rehabilitation professionals still have doubts about its exercise safety due to its vigorousness,which restricts its application in the cardiac rehabilitation.This article aims to introduce HIIT in the aspects of the definition,the indications and contraindications,and the effects on cardiopulmonary functions,laboratory parameters,endothelial functions and the quality of life in patients with coronary artery disease.Furthermore,based on the previous reports that the combination of drugs and exercises can better improve the indicators of patients,we postulate that the implementation of HIIT combined with drugs may impose a positive effect on patients with coronary heart disease,which may provide new ideas and directions for clinical trial and exercise rehabilitation.