基于心肺运动试验的精准运动处方在肥胖患者运动中的指导价值及安全性研究

Value of precision exercise prescription based on cardiopulmonary exercise testing in guiding exercise of obese patients and its safety

目的探讨基于心肺运动试验的精准运动处方在肥胖患者运动中的指导价值及安全性。方法将172例肥胖患者按照随机数字表法分为2组。对照组85例患者根据自身喜好、耐受性给予相应的运动,观察组87例患者基于心肺运动试验结果制订个性化运动处方进行精准运动干预。运动6个月后,评估患者运动效果,比较2组心肺运动试验结果、运动能力、血脂水平、体质量相关指标、依从性及运动安全性的差异。结果观察组运动6个月后心肺运动试验中无氧阈(AT)、峰值摄氧量(V_(O2 peak))及峰值氧脉搏高于对照组,差异有统计学意义(P<0.05);观察组运动6个月后6 min步行距离测定(6MWD)、高密度脂蛋白胆固醇(HDL-C)高于对照组,总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)低于对照组,差异有统计学意义(P<0.05);观察组运动6个月后体质量指数(BMI)、腰围及臀围低于对照组,运动6个月遵医运动、遵医饮食及定期复查依从性高于对照组,低血糖、心前区不适感、饥饿感发生率低于对照组,差异有统计学意义(P<0.05)。结论肥胖患者运动指导中采用基于心肺运动试验的精准运动处方,有助于改善患者心肺功能及运动能力,调节患者血脂,降低体质量相关指标,运动安全性和依从性较高。

Objective To investigate value of precision exercise prescription based on cardiopulmonary exercise testing in guiding exercise of obese patients and its safety.Methods A total of 172 obese patients were divided into two groups by random number table method.The control group(n=85) was given corresponding exercise according to their own preferences and tolerance, and the observation group(n=87) was given individualized exercise prescription for precise exercise intervention based on the results of cardiopulmonary exercise test.After 6 months of exercise, the exercise effects of patients were evaluated, and the differences in results of cardiopulmonary exercise test, exercise ability, blood lipid level, body-weight related indicators, compliance and exercise safety were compared between the two groups.Results After 6 months of exercise, the anaerobic threshold(AT), peak oxygen consumption(V_(O2 peak)), and peak oxygen pulse during cardiopulmonary exercise testing in the observation group were higher than those in the control group(P<0.05).The 6 min walking distance(6 MWD) and high density lipoprotein cholesterol(HDL-C) were higher than those of the control group, total cholesterol(TC), triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) were lower than those of the control group(P<0.05).After 6 months of exercise, the body mass index(BMI), waist circumference and hip circumference of the observation group were lower than those of the control group, the compliance of exercise, diet following the doctor′s advice and regular reexamination after 6 months of exercise were higher than those of the control group, and the incidence rates of hypoglycemia, precardiac discomfort and hunger were lower than those of the control group, and the differences were statistically significant(P< 0.05).Conclusion The prescription of precision exercise based on cardiopulmonary exercise testing for exercise guidance in obese patients is helpful for improving patients′ cardiopulmonary function and exercise capacity, regulate patients’ blood lipids, reduce body weight related indexes, have higher exercise safety and compliance.