弹力带抗阻练习结合呼吸训练对冠心病患者经皮冠状动脉介入术后心肺功能及运动耐力的效果分析

Efficacy of elastic-band anti-resistance practice with breathing training on cardiopulmonary function and athletic endurance in coronary heart disease patients after percutaneous coronary intervention

摘要:

目的 探讨弹力带抗阻练习结合呼吸训练对提高经皮冠状动脉介入(PCI)术后患者心肺功能及运动耐力的影响。方法 选择2016年7月至2016年8月解放军总医院心血管内科常规复诊的PCI术后患者77例,所有患者均接受弹力带抗阻训练,将患者分为弹力带抗阻练习结合呼吸训练组(呼吸训练组)41例和常规弹力带抗阻训练组(对照组)36例,进行为期16周的规律康复训练,每周3次,隔日1次。比较2组训练前后心肺运动相关指标变化。采用SPSS 16.0统计软件对数据进行分析,根据数据类型,组间比较采用t检验或卡方检验。结果 呼吸训练组患者锻炼后与锻炼前比较,最大运动负荷(Mets_max)、最大摄氧量(VO_2max)、最大公斤摄氧(VO₂/kg_max)显著升高(P＜0.01),Borg劳累度评估量表(Borg)评分显著降低(P＜0.01),最大氧脉搏(VO_2max/HR)明显升高(P＜0.05)；对照组患者锻炼后最大心率(HR_max)及无氧阈心率(HRAT)明显低于锻炼前,差异有统计学意义；2组比较,呼吸训练组患者锻炼后Mets_max[(6.03±1.63) vs(5.20±1.21)METs]、VO₂/kg_max[(21.08±5.72) vs(18.12±4.29)ml/(kg·min)]及无氧阈公斤摄氧(VO₂/kgAT)[(16.10±4.80) vs (14.49±4.46) ml/(kg·min)]显著高于对照组,差异有统计学意义(P<0.05)。呼吸训练组锻炼后与锻炼前比较,二氧化碳通气当量(VE/VCO₂)显著降低,第1 秒用力呼气末容积(FEV1)及最大通气量(MVV)显著升高,差异均有统计学意义(P<0.01)；对照组锻炼后VE/VCO₂较锻炼前显著降低,差异有统计学意义(P<0.05)；2组比较,呼吸训练组锻炼后FEV1[(5.42±1.72) vs (2.42±0.85)L]及MVV[(111.24±9.50) vs (95.80±6.23)L]显著升高,差异有统计学意义(P<0.01)。结论 与常规弹力带抗阻练习比较,弹力带抗阻练习结合呼吸训练更能有效提高PCI术后患者运动耐力并改善心肺功能。

Abstract:

Objective To determine the effect of elastic-band anti-resistance practice with breathing training on the cardiopulmonary function and athletic endurance in the coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI). Methods A total of 77 CHD patients who underwent PCI surgery and conventional outpatient follow-up in our department from July to August 2016 were enrolled in this study. Thirty-six patients (control group) took conventional elastic-band anti-resistance practice as a regular rehabilitation training for once per 2 days, 3 times a week, for 16 weeks, and the other 41 cases (breathing training group) took same practice combined with breathing training. The indicators of cardiopulmonary exercise testing before and after the training were compared between them. SPSS statistics 16.0 was used to analyze the data. According to the data type, Student′s t test or Chi-square test was adopted for the comparison between the 2 groups. Results After exercise, the patients of breathing training group had significantly increased maximal oxygen pulse (VO_2max/HR, P<0.05), and more obviously elevated maximal metabolic equivalent of task (Mets_max), maximal oxygen uptake (VO_2max), and maximal oxygen uptake every kilogram (VO₂/kg_mx, P<0.01), but notably decreased Borg rate of perceived exertion scale (P<0.01). While, in the control group, maximal heart rate (HR_max) and anaerobic threshold heart rate (HRAT) were significantly reduced after exercise (P<0.05). When compared with the control group, Mets_max [(6.03±1.63) vs(5.20±1.21) METs], VO₂/kg_max [(21.08±5.72) vs (18.12±5.72) ml/(kg·min)] and anaerobic threshold oxygen uptake every kilogram [VO₂/kgAT, (16.10±4.80) vs (14.49±4.46) ml/(kg·min)] were significantly higher in the breathing training group after exercise (P<0.05). Exercise decreased ventilatory equivalent for carbon dioxide (VE/VCO₂), and improved forced expired volume in one second (FEV1) and maximal voluntary ventilation (MVV) in the breathing training group (P<0.01), while only significantly decreased VE/VCO₂ in the control group (P<0.05). The breathing training group obtained significantly increased FEV1 [(5.42±1.72) vs(2.42±0.85) L] and MVV [(111.24±9.50) vs(95.80±6.23) L] than the control group (P<0.01). Conclusion Compared with conventional elastic-band anti-resistance practice, combination with breathing training can greatly improve the athletic endurance and cardiopulmonary function in the CHD patients after PCI.