居家心脏康复和中心心脏康复对冠心病患者心肺适能的影响

Effects of home-based cardiac rehabilitation and center-based cardiac rehabilitation on cardiopulmonary fitness in patients with coronary heart disease

摘要:

目的 探索居家心脏康复(HBCR)和中心心脏康复(CBCR)对冠心病(CHD)患者心肺适能的影响。方法 选取2018年11月至2019年10月在解放军总医院心脏康复中心门诊就诊的18~80岁的CHD患者,采用随机数表和信封法将患者分为HBCR组和CBCR组,分别以HBCR或CBCR干预3个月。对比2组患者干预前后的峰值摄氧量(peak VO₂)。采用SPSS 25.0软件进行统计分析。组间比较分别采用卡方检验、t检验或Mann-Whitney U检验。结果 纳入191例患者,HBCR组92例,CBCR组99例。2组患者基线水平均衡可比。HBCR组患者干预后peak VO₂水平高于干预前peak VO₂水平,差异有统计学意义[(20.5±4.7)和(19.2±3.9)ml/(kg·min)； P =0.002]; CBCR组患者在干预后peak VO₂水平高于干预前peak VO₂水平,差异有统计学意义[(21.2±4.8) 和 (19.9±4.4)ml/(kg·min)；P=0.001]。但2组患者干预后peak VO₂差异无统计学意义(P=0.331); HBCR和CBCR组患者干预后peak VO₂的改善程度差异无统计学意义[1.2(-1.2,3.5)和 1.1(-0.5,3.5)ml/(kg·min)； P=0.630]; HBCR和CBCR组患者干预后peak VO₂改善程度占干预前peak VO₂比率差异无统计学意义[0.1(-0.1,0.2)和0.1(0.0,0.2)；P=0.610]。结论 HBCR和CBCR均可提高CHD患者心肺适能,且HBCR对心肺适能的改善效力与CBCR无差异。

Abstract:

Objective To determine the effects of home-based cardiac rehabilitation (HBCR) and center-based cardiac rehabilitation (CBCR) on cardiopulmonary fitness in patients with coronary heart disease (CHD). Methods The CHD patients (18-80 years old) who visited the Clinic of Cardiac Rehabilitation Center of Chinese PLA General Hospital from November 2018 to October 2019 were subjected in this study, and were randomly divided into HBCR and CBCR groups. They were given the HBCR program or CBCR program respectively for 3 months. Then peak oxygen uptake (peak VO₂) were compared before and after the intervention and between the 2 groups. Statistical analyses were conducted by SPSS statistics 25.0. Intergroup differences were analyzed by Chi-square test, student′s t test, or Mann-Whitney U test for different data types. Results For the 191 enrolled patients, 92 were assigned into HBCR group and 99 into CBCR group. There were no statistical differences in the baseline data between the 2 groups. After intervention, peak VO₂ level was significantly increased in the HBCR group [(20.5±4.7) vs(19.2±3.9) ml/(kg·min); P=0.002] and the CBCR group [(21.2±4.8) vs (19.9±4.4) ml/(kg·min); P=0.001]. But no statistical difference was seen in the level between HBCR and CBCR groups after the intervention (P=0.331), in the improvement of the level after the intervention [1.2 (-1.2,3.5) vs 1.1 (-0.5,3.5) ml/(kg·min); P=0.630], or in the ratio of the improvement after the intervention to the level before [0.1 (- 0.1,0.2) vs 0.1 (0.0,0.2); P=0.610]. Conclusion Both HBCR and CBCR can improve the cardiopulmonary fitness in the CHD patients. And the improvement of the cardiopulmonary fitness by HBCR is equal to that of CBCR.