居家运动康复对不同程度冠状动脉血运重建患者心肺功能的影响

Effect of home exercise rehabilitation on cardiopulmonary function in patients with varying degrees of coronary revascularization

目的探究居家运动康复对不同程度冠状动脉血运重建患者心肺功能的影响。方法从心脏康复中心数据库中选择2020年9月—2022年9月确诊为急性冠脉综合征并行经皮冠状动脉介入治疗,术后行居家运动康复的患者93例。依据剩余syntax评分(rSS)将患者分为rSS<8分组51例和rSS≥8分组42例。采用心肺功能运动试验(CPET)评估心肺功能,比较两组患者居家运动康复前及居家运动康复6个月后CPET参数的变化。结果居家运动康复6个月后,两组患者无氧阈时的氧摄取量(VO_(2)at AT)、峰值氧摄取量(VO_(2)at peak)、无氧阈时的氧脉率(VO_(2)/HR at AT)、峰值氧脉率(VO_(2)/HR at peak)较居家运动康复前升高,差异均有显著性(t=-2.953~-5.483,P<0.05)。两组患者居家运动康复前后无氧阈时的二氧化碳通气效率(VE/VCO_(2)at AT)的差值、峰值二氧化碳通气效率(VE/VCO_(2)at peak)差值比较差异有显著性(Z=-2.046、-2.206,P<0.05)。结论居家运动康复可以改善经皮冠状动脉介入治疗术后急性冠脉综合征患者的心肺功能,且居家运动康复对rSS≥8分的患者心功能获益更显著。

Objective To investigate the effect of home exercise rehabilitation on cardiopulmonary function in patients with varying degrees of coronary revascularization.Methods A total of 93 patients who were diagnosed with acute coronary syndrome and underwent percutaneous coronary intervention from September 2020 to September 2022 and received home exercise rehabilitation were selected from the database of Cardiac Rehabilitation Center.According to the residual syntax score(rSS),the patients were divided into rSS<8 group with 51 patients and rSS≥8 group with 42 patients.The cardiopulmonary function exercise test(CPET)was used to evaluate cardiopulmonary function,and the two groups were compared in terms of the changes in CPET parameters after 6 months of home exercise rehabilitation.Results After 6 months of home exercise rehabilitation,both groups had significant increases in oxygen uptake at anaerobic threshold,peak oxygen uptake,oxygen pulse rate at anaerobic threshold,and peak oxygen pulse rate(t=-2.953--5.483,P<0.05).There were significant differences in the changes of carbon dioxide ventilation efficiency at anaerobic threshold and peak carbon dioxide ventilation efficiency after home exercise rehabilitation between the two groups(Z=-2.046,-2.206,P<0.05).Conclusion Home exercise rehabilitation can improve the cardiopulmonary function of patients with acute coronary syndrome after percutaneous coronary intervention and bring more benefits for cardiac function in patients with rSS≥8.