自主呼吸训练对稳定型冠心病心率变异性和心率-压力乘积的影响效果

The rehabilitation effects of spontaneously breathing training on heart rate variability and heart-pressure product of patients with stable coronary heart disease

目的 探讨自主呼吸训练影响稳定型冠心病心率变异性和心率-压力乘积的护理康复效果。方法 选取120例稳定型冠心病患者平均分为观察组和对照组2组,每组60例。对照组患者给予常规健康宣教,观察组患者则在常规健康宣教的基础上给予自主呼吸训练。分析2组患者康复训练前后心率变异性[1 d正常RR标准差异(SDNN)、1 d内5 min时段RR间期均值标准差(SDANN)、连续RR间期差值均方根(RMSSD)和相邻正常RR间期差值>50 ms百分比(PNN50)]和心率-压力乘积的差异,同时记录康复训练后患者的动态血压参数[24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、白昼平均收缩压(dSBP)、白昼平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(n DBP)]和血脂指标[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],并统计患者不良反应发生率。结果 康复训练后,与对照组患者相比,观察组患者的24 h SBP、24 h DBP、dSBP、dDBP、nSBP、nDBP、TC、TG和LDL-C均减小,HDL-C则较大,差异均有统计学意义(P<0.05)。康复训练前2组患者的心率变异性和心率-压力乘积差异无统计学意义(P>0.05),在康复训练后观察组患者的SDNN、SDANN、RMSSD和PNN50显著高于对照组,平均心率、平均血压和平均心率血压乘积则显著低于对照组(P<0.05)。观察组患者不良反应发生率低于对照组(P<0.05)。结论 自主呼吸训练对稳定型冠心病患者的心率变异性和心率-压力乘积的护理康复效果显著,具有良好的有效性及安全性,值得临床推广。

Objective To investigate nursing and rehabilitation effects of spontaneously breathing training on heart rate variability and heart-pressure product of patients with stable coronary heart disease(CHD).Methods A total of 120 patients with stable CHD were randomly divided into control group and observation group,with 60 cases in each group.The patients in control group were received routine health education,however,the patients in observation group,on the basis of control group,were given spontaneously breathing training.After the intervention the heart rate variability and heart-pressure product were observed and compared between the two groups.Moreover the dynamic blood pressure parameters and blood lipid indexes as well as the incidence of adverse reactions were also observed and compared between the two groups.Results After rehabilitation training,as compared with those in control group,the levels of 24h SBP,24h DBP,dSBP,dDBP,nSBP,nDBP,TC,TG and LDL-C in observation group were significantly decreased,however,HDL-C levels were significantly increased(P<0.05).Before rehabilitation training,there were no significant differences in the heart rate variability and heart-pressure product between the two groups(P>0.05).After rehabilitation training,the levels of SDNN,SDANN,RMSSD and PNN50 in observation group were significantly higher than those in control group,while average heart rate,average blood pressure and product of average heart rate and blood pressure were significantly lower than those in control group(P<0.05).In addition the incidence of ADR in observation group was 5.00%,which was significantly lower than that(35.00%)in control group(P<0.05).Conclusion The effects of spontaneously breathing training on the heart rate variability and heart-pressure product of patients with stable CHD are significant,with good effectiveness and safety,therefore,it is worth using widely in clinical practice.