临床研究

以个体化运动训练为核心的心脏康复方案对冠心病患者经皮冠状动脉介入治疗后康复效果的影响

  • 葛书萍 ,
  • 陈伟 ,
  • 贾欣欣 ,
  • 高民 ,
  • 何民 ,
  • 秦存宇
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  • 1.徐州医科大学附属徐州康复医院 (江苏 徐州 221000 )
    2.徐州市中心医院 (江苏 徐州 221000 )

收稿日期: 2024-01-11

  网络出版日期: 2024-09-30

基金资助

徐州市引进临床医学专家团队项目(2018TD007);徐州市科技计划项目(KC21156);江苏医药职业学院临床教学基地科研发展专项课题立项项目(20219130)

Effect of individual exercise training as the core cardiac rehabilitation program on the rehabilitation of patients with coronary heart disease after percutaneous coronary intervention

  • Shuping GE ,
  • Wei CHEN ,
  • Xinxin JIA ,
  • Min GAO ,
  • Min HE ,
  • Cunyu. QIN
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  • Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University,Xuzhou 221000,China

Received date: 2024-01-11

  Online published: 2024-09-30

摘要

目的 探讨以个体化运动训练为核心的心脏康复方案对冠心病(CHD)患者经皮冠状动脉介入(PCI)治疗后康复效果的影响。 方法 选择2021年1月至2023年12月接受PCI治疗的81例CHD患者,以简单随机数字表法随机分成观察组(41例)、对照组(40例),对照组予以常规术后康复方案干预,观察组予以个体化运动训练为核心的心脏康复方案干预。比较两组患者康复效果、干预前和干预3个月后心功能[左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、运动耐力[6分钟步行距离(6MWD)、最大运动负荷]、生活质量[西雅图心绞痛调查量表(SAQ)评分]水平变化。 结果 观察组康复总有效率较对照组更高(P < 0.05)。干预前,两组LVEF、LVEDD、6MWD、最大运动负荷及SAQ量表各维度评分比较无差异(P > 0.05);干预后,两组LVEF、6MWD、最大运动负荷及SAQ量表各维度评分均高于干预前,观察组高于对照组(t = 3.345、2.480、3.165、5.016、2.059、4.582、7.443、3.353,P < 0.05),两组LVEDD均低于干预前,观察组低于对照组(t = 3.335,P < 0.05)。 结论 以个体化运动训练为核心的心脏康复方案可改善CHD患者PCI治疗后心功能、运动耐力,并提升患者生活质量,值得临床应用。

本文引用格式

葛书萍 , 陈伟 , 贾欣欣 , 高民 , 何民 , 秦存宇 . 以个体化运动训练为核心的心脏康复方案对冠心病患者经皮冠状动脉介入治疗后康复效果的影响[J]. 实用医学杂志, 2024 , 40(18) : 2607 -2611 . DOI: 10.3969/j.issn.1006-5725.2024.18.017

Abstract

Objective To investigate the effect of individual exercise training on the rehabilitation of patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods A total of 81 patients between January 2021 and December 2023 were randomly allocated into an observation group (n = 41) and a control group (n = 40) using a simple random number Tab.method. The control group received routine postoperative rehabilitation intervention, while the observation group received individualized exercise training as the core component of cardiac rehabilitation intervention. The study compared the effects of rehabilitation, cardiac function parameters [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)], exercise endurance measures [6-minute walking distance (6MWD)], and quality of life assessed by Seattle Angina Pecina Scale (SAQ) scores between the two groups before and after a three-month intervention period. Results The total recovery response rate in the observation group was higher than that in the control group (P < 0.05). LVEF, LVEDD, 6 MWD, maximum exercise load and SAQ scales (P > 0.05), LVEF were higher than before intervention (t = 3.345,2.480,3.165,5.016,2.059,4.582,4.443,3.353, P < 0.05), and LVEDD was lower than before intervention (t = 3.335, P < 0.05). Conclusion The individualized exercise training-based cardiac rehabilitation program demonstrates potential for enhancing cardiac function and exercise endurance in patients with CHD following PCI, thereby improving their overall quality of life. This finding holds significant clinical implications.

参考文献

1 王莹澄,桂彩红,毛芳. 以时机理论为中心的延续性护理模式在冠心病PCI术后患者中的应用[J]. 检验医学与临床, 2022, 19(6):755-757.
2 PYMER S, NICHOLS S, PROSSER J, et al. Does exercise prescription based on estimated heart rate training zones exceed the ventilatory anaerobic threshold in patients with coronary heart disease undergoing usual-care cardiovascular rehabilitation? A United Kingdom perspective[J]. Eur J Prev Cardiol, 2020,27(6):579-589. doi:10.1177/2047487319852711
3 王丹红,林凡菊,祝玮容. 基于FMEA模式的康复护理在冠心病合并糖尿病患者PCI围术期的干预效果[J]. 海南医学, 2022,33(20):2680-2683.
4 刘云娥,王菁. 基于微信平台延续护理干预对冠心病患者PCI术后负性情绪,自我效能及生活质量的影响[J]. 西部中医药, 2022,35(2):122-125.
5 MALIAN H M, SMITH P J, HOFFMAN B, et al. Effects of Acute Exercise on Anxiety Ratings in Patients With Coronary Heart Disease and Elevated Anxiety[J]. J Cardiopulm Rehabil Prev, 2021,41(4):277-281. doi:10.1097/hcr.0000000000000579
6 中华医学会心血管病学分会介入心脏病学组,中华医学会心血管病学分会动脉粥样硬化与冠心病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,等.稳定性冠心病诊断与治疗指南[J]. 中华心血管病杂志,2018,46(9):680-694. doi:10.3760/cma.j.issn.0253-3758.2018.09.004
7 中国医师协会心血管内科医师分会预防与康复专业委员会. 经皮冠状动脉介入治疗术后运动康复专家共识[J]. 中国介入心脏病学杂志,2016,24(7):361-369.
8 刘同想. 西雅图心绞痛调查量表对冠心病患者机体功能及生活质量的评估研究[J]. 中国行为医学科学, 1997, 6(2):127-129.
9 CHAIR S Y, ZOU H, CAO X. A systematic review of effects of recorded music listening during exercise on physical activity adherence and health outcomes in patients with coronary heart disease[J]. Ann Phys Rehabil Med, 2021,64(2):101447. doi:10.1016/j.rehab.2020.09.011
10 TRACHSEL L D, BOIDIN M, HENRI C, et al. Women and men with coronary heart disease respond similarly to different aerobic exercise training modalities: A pooled analysis of prospective randomized trials[J]. Appl Physiol Nutr Metab, 2021,46(5):417-425. doi:10.1139/apnm-2020-0650
11 王宝玉,翁琴,李玉平. 延续性护理对冠心病PCI术后患者预后的影响[J]. 中华现代护理杂志, 2022, 28(2):229-232.
12 BOIDIN M, TRACHSEL L D, NIGAM A, et al. Non-linear is not superior to linear aerobic training periodization in coronary heart disease patients[J]. Eur J Prev Cardiol, 2020,27(16):1691-1698. doi:10.1177/2047487319891778
13 SANTOS V, MASSU?A L M, ANGARTEN V, et al. Arterial Stiffness following Endurance and Resistance Exercise Sessions in Older Patients with Coronary Artery Disease[J]. Int J Environ Res Public Health, 2022,19(22):14697. doi:10.3390/ijerph192214697
14 冯舒爽,华俊,魏睿宏,等. 改良早期心脏康复方案在经皮冠状动脉介入术后患者中的应用[J]. 中华护理杂志,2020,55(9):1330-1335.
15 张振英,孙兴国,孙晓静,等. 个体化精准运动为核心的整体康复方案对冠心病介入治疗术后患者整体功能再提高的临床研究[J]. 中国应用生理学杂志,2021,37(2):202-207.
16 王嘉琪,王晓文,蒋成龙,等. 个体化心脏运动康复训练对老年心力衰竭患者生活质量测定量表评分的影响研究[J]. 山西医药杂志,2021,50(12):1994-1997.
17 张艳梅,徐玉兰,梁媛,等. 个体化心脏运动康复训练联合简式太极训练对稳定性慢性心力衰竭患者心肺功能,心理状态和生活质量的影响[J]. 现代生物医学进展, 2022,22(11):2057-2060.
18 WANG Z, ZHANG Y, WANG Y, et al. Kinesiophobia and its associated factors in patients with coronary heart disease: A cross-sectional study based on latent feature analysis[J]. BMJ Open, 2023,13(7):e072170. doi:10.1136/bmjopen-2023-072170
19 谢剑,肖青叶,朱慧,等. 个体化运动训练在射血分数保留型心力衰竭患者中的应用[J]. 心脑血管病防治, 2021,21(1):87-89.
20 苏晟杰,梁志德,原阳. 高强度间歇训练的运动预适应预防肥胖青少年运动性心血管事件的发生[J]. 解剖学杂志, 2021, 44(1):56-56.
21 张振英,孙兴国,孙晓静,等. 个体化精准运动为核心的整体康复方案对冠心病介入治疗术后患者整体功能再提高的临床研究[J]. 中国应用生理学杂志,2021,37(2):202-207.
22 ULLAH A, KUMAR M, SAYYAR M, et al. Revolutionizing Cardiac Care: A Comprehensive Narrative Review of Cardiac Rehabilitation and the Evolution of Cardiovascular Medicine[J]. Cureus, 2023,15(10):46469.
23 DIBBEN G O, FAULKNER J, OLDRIDGE N,et al. Exercise-based cardiac rehabilitation for coronary heart disease: A meta-analysis[J]. Eur Heart J, 2023,44(6):452-469.
24 DEKA P, PATHAK D, KLOMPSTRA L, et al. High-Intensity Interval and Resistance Training Improve Health Outcomes in Older Adults With Coronary Disease[J]. J Am Med Dir Assoc, 2022,23(1):60-65. doi:10.1016/j.jamda.2021.05.034
25 VILLELABEITIA-JAUREGUIZAR K, VICENTE-CAMPOS D, BERENGUEL SENEN A, et al. Mechanical efficiency of high versus moderate intensity aerobic exercise in coronary heart disease patients: A randomized clinical trial[J]. Cardiol J, 2019,26(2):130-137.
26 WU C, BU R, WANG Y, et al. Rehabilitation effects of circuit resistance training in coronary heart disease patients: A systematic review and meta-analysis[J]. Clin Cardiol, 2022,45(8):821-830. doi:10.1002/clc.23855
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