心脏康复训练在改善老年慢性冠心病患者日常生活能力及心脏功能中的价值

Value of cardiac rehabilitation training in improving daily living ability and cardiac function in elderly patients with chronic coronary heart disease

【摘要】目的 探讨心脏康复训练在改善老年慢性冠心病患者日常生活能力、心脏功能及生活质量中的价值。方法 选取2019年5月至2021年10月于首都医科大学附属北京天坛医院择期行经皮冠状动脉介入(PCI)治疗的160例老年慢性冠心病稳定性心绞痛患者为研究对象。采用随机数表法将患者分为观察组(n=80)与对照组(n=80)。对照组PCI后接受常规干预,观察组在常规干预基础上开展心脏康复训练干预。比较两组患者干预前后心功能[左室射血分数(LVEF)、左室舒张末期容积(LVEDV)]、生活质量及日常生活能力,同时统计患者PCI后6个月内心血管不良事件发生情况。采用SPSS 22.0统计软件进行数据处理,根据数据类型分别采用单因素方差分析、t检验或χ²检验进行组间比较。结果 观察组干预后LVEF显著高于对照组,而LVEDV显著低于对照组,差异有统计学意义(t=5.852、12.850,P＜0.05)。观察组干预后生活质量各维度得分及干预后4、6个月日常生活能力得分显著高于对照组,差异有统计学意义(t=2.525、3.682、3.099、2.857、2.497、2.167、2.243,P＜0.05)。观察组心血管不良事件总发生率显著低于对照组,差异有统计学意义(χ²=4.717,P＜0.05)。结论 心脏康复训练用于老年慢性冠心病稳定性心绞痛患者能够改善心功能,有利于提升患者日常生活能力与生活质量,值得临床推广应用。

基金项目:国家自然科学基金(82000323)；北京市自然科学基金(2020216)；首都医科大学附属北京天坛医院青年课题(2018-YQN-29)

【Abstract】Objective To explore the value of cardiac rehabilitation training in improving the daily living ability, cardiac function and quality of life of the elderly patients with chronic coronary heart disease. Methods The study objects included 160 elderly patients with stable angina pectoris with chronic coronary heart disease, who underwent elective percutaneous coronary intervention (PCI) in Beijing Tiantan Hospital affiliated to Capital Medical University from May 2019 to October 2021. The patients were divided into an observation group (n=80) and control group (n=80) by random number table method. The control group received routine intervention after PCI, and the observation group received cardiac rehabilitation training intervention on the basis of routine intervention. The cardiac function [left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV)], quality of life and daily living ability were compared between the two groups before and after intervention. The incidence of adverse cardiovascular events within six months after PCI was counted. SPSS 22.0 was used to process the data, and one-way ANOVA, t test orχ² test was used for inter-group comparison according to the data type. Results After intervention, LVEF in the observation group was significantly higher, and LVEDV was significantly lower than that in the control group (t=5.852,12.850; P<0.05). The scores of each dimension of the quality of life and daily living ability at four and six months after intervention in the observation group were significantly higher than those in the control group, with statistically significant differences (t=2.525,3.682,3.099,2.857,2.497,2.167,2.243; P<0.05). The overall incidence of cardiovascular adverse events in the observation group was significantly lower than that in the control group , and the difference was statistically significant (χ²=4.717; P<0.05). Conclusion Cardiac rehabilitation training in the elderly patients with stable angina pectoris due to chronic coronary heart disease can improve cardiac function, contributing to the improvement of their daily living ability and quality of life, and it is worthy of clinical promotion and application.

This work was supported by the National Natural Science Foundation of China (82000323), Natural Science Foundation of Beijing (2020216) and the Youth Project of Beijing Tiantan Hospital Affiliated to Capital Medical University (2018-YQN-29).