周密+李云+钟才秀+杨志华

[摘要]目的 觀察稳定期冠心病患者康复运动治疗后心功能的变化。方法 选择2016年6月～2017年1月我院心血管内科收治的160例稳定期冠心病患者，将其分为治疗组（90例）及对照组（70例）。对照组仅给予冠心病基础药物治疗，治疗组在给予药物治疗的同时完成统一制订的康复运动治疗方案，比较治疗前及治疗4周后两组患者各项心功能指标的变化。治疗4周后再将治疗组分为短程组（50例，治疗4周）及长程组（40例，治疗12周），比较短程组、长程组及对照组患者各项心功能指标的变化。结果 与对照组比较，治疗4周后治疗组在6 min步行试验、最大代谢当量（METs）、NYHA心功能分级及左室射血分数均显著改善（P<0.05）。长程组治疗12周后6 min步行试验、METs、NYHA心功能分级及左室射血分数均显著优于同组治疗4周后、短程组12周后和对照组12周后（P<0.05）。试验12周后，短程组与对照组各项指标差异无统计学意义（P>0.05）。结论 康复运动治疗有助于协助药物治疗改善稳定期冠心病患者的心功能，且持续的有规律的康复运动治疗效果更显著。

[关键词]心脏康复；冠心病；心功能；6分钟步行试验；最大代谢当量；左室射血分数

[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0032-04

Influence of rehabilitation exercise on cardiac function in patients with coronary heart disease at a stable stage

ZHOU Mi LI Yun ZHONG Cai-xiu YANG Zhi-hua

Department of Rehabilitation Medicine，the Third Affiliated Hospital of Nanchang University，Jiangxi Province，Nanchang 330008，China

[Abstract]Objective To observe the changes of cardiac function in patients with coronary heart disease （CHD） at a stable stage after rehabilitation exercise.Methods A total of 160 patients with stable CHD treated in Department of Cardiovascular Medicine of our hospital were selected and divided into treatment group （n=90） and control group （n=70）.In the control group，the basic medication on CHD was provided，while in the treatment group，besides the basic medication，a unified regimen of rehabilitation exercise was added.The changes of cardiac function indexes before experiment and four-week after therapy were compared.What′s more，participants in the treatment group were further divided into short-term treatment group （4-week therapy，n=50） and long-term treatment group （12-week therapy，n=40）.The cardiac functions in the short-term treatment，long-term treatment，and control groups were compared.Results Compared with the control group，the indexes of 6-minute walkingtest，maximal metabolic equivalent （METs），grading of NYHA cardiac function，and left ventricular ejection fraction （LVEF） were greatly improved in the treatment group after 4 weeks of treatment （P<0.05）.The indexes of 6-minute walkingtest，METs，grading of NYHA cardiac function，and LVEF in the long-term treatment group were superior to those with only 4-week treatment in the same group，the short-term treatment group after 12 weeks，and the control group after 12 weeks （P<0.05）.After 12 weeks，the indexes in the short-term treatment group and control group were not displayed statistical differences （P>0.05）.Conclusion Rehabilitation exercise therapy is beneficial to improve the cardiac function in patients with stable CHD，and the effect is more significant in a continuous and regular way.endprint

[Key words]Cardiac rehabilitation；Coronary heart disease；Cardiac function；6-minute walking test；Maximal metabolic equivalent；Left ventricular ejection fraction

WHO预测到2020年我国以冠心病为主的心血管疾病的发病率将升至顶峰[1-2]。2014年《中国心血管病报告》显示了心血管疾病人数达2.9亿，全国冠心病介入治疗人数45万余人，每年以10%～20%的比例增长[3]。而内科治疗仍无法明显改善冠心病患者心功能及生存质量，心脏介入治疗也仅仅适用于部分患者。因此，心脏康复治疗作为冠心病等心血管疾病的辅助治疗成为了国内外心血管学科的发展热点。本研究针对稳定期冠心病患者进行康复运动治疗，进一步探讨心脏康复运动对冠心病患者心功能的影响，以期改善患者的心功能和生存质量。……