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冠心病患者PTCA术前后及康复运动后的心肺功能评价

陈 刚 李京平 孙福成 何 青 季福绥 王茂斌 邓开伯

  摘要 为比较冠心病患者PTCA术或PTCA加支架术前后和康复运动后的心肺功能指标,确定PTCA术或加支架术的急性效果,对15例急性心肌梗塞和不稳定型心绞痛患者于PTCA术或加支架术前后和康复运动训练后进行运动心肺功能评定。结果:PTCA术或加支架术后患者的运动时间和最大运动负荷量明显提高(P<0.05),运动中的最大心率和心率增值非常显著提高(P<0.05和0.01),运动诱发的心电图ST段压低显著改善(P<0.002),最大代谢当量(METs)、每分通气量(E)和最大氧耗量(O2max)显著提高(P<0.002、0.005和0.05);康复运动训练8~12周后患者的运动时间非常显著延长(P<0.01),METs、O2max和E进一步显著提高(P<0.05)。提示PTCA术或加支架术配合康复运动训练可显著地提高患者的生活质量。
  关键词 冠心病; 心肺运动试验; 康复运动; 心脏功能容量

Evaluation of Cardiopulmonary Function before and after PTCA and Rehabilitation
Exercise Training in Patients with Coronary Heart Diseases

Chen Gang, Li Jingping, Sun Fucheng, et al

Department of Rehabilitation Medicine, Beijing Hospital, Beijing 100730

  Abstract The cardiopulmonary function in patients with coronary heart diseases before and after PTCA or intracoronary stent implantation and after rehabilitation exercise training was studied, and the effect of PTCA and probe guidelines for exercise prescription, characteristics as well as benefits of exercise training in these patients was investigated. The cardiopulmonary exercise function evaluation was performed in 15 patients with myocardial infarction and unstable angina pectoris pre-and post-PTCA or intracoronary stent implantation and after rehabilitation exercise training for 8 to 12 weeks. The results showed that after PTCA or intracoronary stent implantation, the total exercise time and maximal work load, the maximal heart rate (HRmax) and the increased value of heart rate (△ HR=HRmax-resting HR), the maximal metabolic equivalents (METs), and maximal oxygen consumption (O2 max) and minute ventilation (VE) were significantly increased, and the ST segment depression induced by exercise was significantly improved (P<0.01 to P<0.05 for all). After exercise training for 8 to 12 weeks, the total exercise time was further significantly increased as compared with that after PTCA (P<0.01), METs, O2max

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