经皮冠状动脉介入术后高危患者适宜靶心率下的有氧运动对心功能影响的研究

Study on the influence of appropriate target rate exercise on cardiac function in high-risk patients after percutaneous coronary intervention

目的:探讨经皮冠状动脉介入(PCI)术后高危患者依据心肺运动功能试验结果制定靶心率的选择方案,并探讨应用该剂量制定的运动处方对高危患者心功能及生活质量的影响。方法:选取吉林大学中日联谊医院2019年1—12月PCI术后的所有174例高危患者,康复治疗组84例患者进行心率及心律监护下以靶心率为依据的有氧运动治疗,对照组90例患者进行居家有氧运动治疗,两组均给予标准化的药物治疗、生活方式指导及心理治疗,检测患者康复治疗前后峰值摄氧量、Weber心功能及生活质量量表评分等指标。结果:两组患者年龄、体质指数、血压、空腹血糖、低密度脂蛋白胆固醇等差异无显著性意义(P>0.05)。与对照组比较,监护下康复治疗组峰值摄氧量变化值(△Peak-VO_(2))[(2.07±1.92)ml/(min·kg)比(-0.70±2.46)ml/(min·kg)]明显改善(P<0.0001);无氧阈时摄氧量变化值(△AT-VO_(2))[(1.71±2.06)ml/(min·kg)比(-0.46±1.98)ml/min/kg]明显改善(P<0.0001);Weber心功能级别有所改善(P=0.028);Mac New评分康复治疗后[(149.88±13.74)比(143.22±12.65)]明显改善(P=0.001)。结论:依据运动心肺功能检测结果选择的靶心率制定PCI术后高危患者的运动处方,并据此进行治疗,在监护心率和心律的条件下可显著改善心功能,提高生活质量。

Objective:To explore the selection program of target heartrate exercise in high-risk patients after percutaneous coronary intervention(PCI)based on the results of cardiopulmonary exercise function test,and to explore the effect of exercise prescription based on this dose on cardiac function and quality of life in high-risk patients.Method:All 174 high-risk patients after PCI in China-Japan Friendship Hospital of Jilin University from January 2019 to December 2019 were selected and divided into supervised rehabilitation treatment group(84 patients)and control group(90 patients)according to whether they received heart rate and aerobic exercise therapy based on target heart rate under heart rate monitoring or domiciliary aerobic exercise therapy.Both groups were given standardized drug therapy,lifestyle guidance and psychotherapy.The indexes of peak oxygen intake,Weber cardiac function and quality of life scale were measured before and after rehabilitation treatment.Result:There were no significant differences in age,body mass index,blood pressure,fasting blood glucose and low density lipoprotein cholesterol between 2 groups(P>0.05).Compared with the control group,the increase of peak oxygen intake[(2.07±1.92)ml/(min·kg)vs.(﹣0.70±2.46)ml/(min·kg)]in the rehabilitation treatment group under monitoring was significantly improved in the rehabilitation treatment(P<0.0001).The difference increase of oxygen uptake of anaerobic threshold[(1.71±2.06)ml/(min·kg)vs.(﹣0.46±1.98)ml/(min·kg)]was significantly improved(P<0.0001).Weber cardiac function level was improved(P=0.028);Mac New heart disease-related quality of life instrument[(149.88±13.74)vs.(143.22±12.65)]was significantly improved(P=0.001).Conclusion:The exercise prescription of high-risk patients after PCI based on the target heart rate selected by the cardiopulmonary function test and under the condition of monitoring heart rate and rhythm results can significantly improve cardiac function and quality of life.