不同运动强度对冠心病患者死亡事件发生风险影响

Effect of different exercise intensity on risk of death events in patients with coronary heart disease

目的探讨不同运动强度对冠心病(CHD)患者死亡事件发生风险的影响。方法选取国家健康与营养检查调查数据库中2007—2018年纳入的3215例CHD患者为研究对象。根据不同运动强度将患者分为不运动组(n=1354)、中强度运动组(n=1230)与高强度运动组(n=631)。记录并比较3组患者的基线资料。采用Kaplan-Meier生存分析对3组患者的终点事件累计发生率进行描述。应用Cox回归模型分析CHD患者发生全因死亡和心源性死亡的危险因素。结果中强度运动组、高强度运动组患者白蛋白、男性比例均高于不运动组,年龄、肌酐及贫血、糖尿病、慢性阻塞性肺疾病、全因死亡、心源性死亡、癌症死亡比例均低于不运动组,差异均有统计学意义(P<0.05);3组患者家庭贫困指数分级、抑郁程度分级比较,差异均有统计学意义(P<0.05)。Kaplan-Meier生存曲线显示,高强度运动组全因死亡、心源性死亡发生率均低于不运动组、中强度运动组,差异均有统计学意义(P<0.05)。Cox回归分析显示,不运动是CHD患者全因死亡和心源性死亡的独立危险因素(P<0.05)。结论中高强度运动与CHD患者全因死亡及心源性死亡发生风险降低相关。

Objective To investigate the effect of different exercise intensity on the risk of death events in patients with coronary heart disease(CHD).Methods A total of 3215 CHD patients from 2007 to 2018 were selected from the National Health and Nutrition Examination Survey database.The patients were divided into no exercise group(n=1354),moderate exercise group(n=1230)and high intensity exercise group(n=631)according to different exercise intensity.The baseline data of the three groups were recorded and compared.Kaplan-Meier survival analysis was used to describe the cumulative incidence of endpoint events in the 3 groups.Cox regression model was used to analyze the risk factors of all-cause death and cardiac death in CHD patients.Results Albumin level and male ratio in the moderate exercise group and the high intensity exercise group were higher than those in the no exercise group,age,creatinine,and the proportions of anemia,diabetes,chronic obstructive pulmonary disease,all-cause death,cardiac death and cancer death were lower than those in the no exercise group,with statistical significance(P<0.05).There were significant differences in family poverty index and depression degree among 3 groups(P<0.05).Kaplan-Meier survival curve showed that the incidence of all-cause death and cardiac death in the high intensity exercise group was lower than that in the no exercise group and the moderate intensity exercise group,and the differences were statistically significant(P<0.05).Cox regression analysis showed that inactivity was an independent risk factor for all-cause death and cardiogenic death in CHD patients(P<0.05).Conclusion Moderate to high intensity exercise is associated with a reduced risk of all-cause death and cardiac death in patients with CHD.