抗阻运动对冠心病患者运动耐量、躯体化症状的影响

Effects of resistance exercise on exercise tolerance and somatization symptoms in patients with coronary artery disease

目的:探究抗阻运动对稳定性冠心病患者的运动耐量、心脏功能、躯体化症状的影响。方法:选择2020年6月至2022年6月于内蒙古科技大学包头医学院第二附属医院行冠脉造影或冠脉CTA检查确诊的不合并心衰的稳定性冠心病患者,按自愿原则入组,最终对照组47例、抗阻运动组58例,均按照运动处方运动12周。采用峰值摄氧量(VO_(2)_(peak))、无氧阈评估患者运动耐量;采用心脏超声心动图二尖瓣舒张早期峰值血流速度/舒张晚期峰值血流速度(E/A)比值评估患者左室舒张功能;采用躯体化症状自评量表(SSS)评估患者的心理健康。随访24周比较两组严重心血管不良事件的发生情况。结果:与运动前比,抗阻运动组运动12周后VO_(2)_(peak)[(17.53±3.92)ml·min^(-1)·kg^(-1)比(20.35±3.70)ml·min^(-1)·kg^(-1)]、无氧阈[(11.60±3.40)ml·min^(-1)·kg^(-1)比(12.62±3.16)ml·min^(-1)·kg^(-1)]、E峰[(0.63±0.14)mm/s比(0.70±0.16)mm/s]、E/A[(0.80±0.14)比(0.91±0.24)]显著升高,静息心率[(76.21±12.70)次/min比(74.36±9.87)次/min]、SSS评分[10.00(5.00,22.25)分比9.50(3.00,21.00)分]显著下降(P均<0.01)。与对照组比,12周后抗阻运动组VO_(2)_(peak)[(18.59±3.93)ml·min^(-1)·kg^(-1)比(20.35±3.70)ml·min^(-1)·kg^(-1)]、E/A[(0.82±0.22)比(0.91±0.24)]显著升高(P均<0.05)。随访24周,两组严重心血管不良事件发生率无显著差异(P=1.000)。结论:抗阻运动可以显著提高冠心病患者的运动耐量,改善心脏舒张功能和心理健康。

Objective:To investigate effects of resistance exercise on exercise tolerance,cardiac function and somatization symptoms in patients with stable coronary artery disease(SCAD).Methods:SCAD patients without heart failure,who were diagnosed with coronary angiography or coronary CTA in Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science&Technology between June 2020 and June 2022 were selected.They were enrolled into groups according to voluntary principle,and 47 cases and 58 cases were finally included in control group and resistance exercise group respectively.Both groups exercised for 12 weeks according to the exercise prescription.Exercise tolerance was assessed using peak oxygen uptake(VO_(2)_(peak))and anaerobic threshold;left ventricular diastolic function was assessed using cardiac echocardiography mitral early-diastolic peak flow velocity/late-diastolic peak flow velocity(E/A);and mental health was assessed using Somatization Symptom Self-rating Scale(SSS).The occurrence of serious cardiovascular adverse events was compared between two groups after 24-week follow-up.Results:Compared with before exercise,after 12-week exercise,there were significant rise in VO_(2)_(peak)[(17.53±3.92)ml·min^(-1)·kg^(-1)vs.(20.35±3.70)ml·min^(-1)·kg^(-1)],anaerobic threshold[(11.60±3.40)ml·min^(-1)·kg^(-1)vs.(12.62±3.16)ml·min^(-1)·kg^(-1)],E peak[(0.63±0.14)mm/s vs.(0.70±0.16)mm/s]and E/A ratio[(0.80±0.14)vs.(0.91±0.24)];and significant reductions in resting heart rate[(76.21±12.70)beats/min vs.(74.36±9.87)beats/min]and SSS score[10.00(5.00,22.25)points vs.9.50(3.00,21.00)points]in resistance exercise group(P<0.01 all).Compared with the control group,VO_(2)_(peak)[(18.59±3.93)ml·min^(-1)·kg^(-1)vs.(20.35±3.70)ml·min^(-1)·kg^(-1)]and E/A ratio[(0.82±0.22)vs.(0.91±0.24)]were significantly higher in resistance exercise group after 12 weeks(P<0.05 both).After 24-week follow-up,there was no significant difference in incidence rate of serious cardiovascular adverse events between two groups(P=1.000).Conclusion:Resistance exercise can significantly increase exercise tolerance,improve cardiac diastolic function and psychological health in patients with coronary artery disease.