经皮冠脉介入术术后不同年长冠心病患者的运动耐量状况及影响因素分析

关键词：经皮冠脉介入术  冠心病  长期  运动耐量  最大摄氧量

Keywords:percutaneous coronary intervention  coronary heart disease  long term  exercise tolerance  maximum oxygen uptake

摘要：

      摘要 目的：调查经皮冠脉介入术(percutaneous coronary intervention， PCI)术后不同年长的冠心病患者的运动耐量状况，并分析其影响因素。 方法：采取回顾性研究，样本来自2017年9月—2021年3月在某三级甲等医院运动测试中心接受心肺运动测试的1116例PCI术后冠心病患者，对一般资料、既往史、工作与体力活动、药物治疗作描述性统计、单因素分析和多元线性回归分析。 结果：性别、文化程度、术后年长、高血压、糖尿病、工作精神紧张程度、工作体力消耗程度、钙拮抗剂对最大摄氧量(maximal oxygen uptake， VO2max)影响显著(P<0.05)，性别、文化程度、术后年长、动脉粥样硬化、糖尿病、吸烟、家务劳动程度对VO2max%影响显著(P<0.05)，年龄、BMI与VO2max和VO2max%的相关性均显著。 结论：PCI术后年长较久的患者群体运动耐量较好，女性的运动耐量优于男性，文化程度、家务劳动程度和运动锻炼程度对运动耐量产生正面影响，吸烟、糖尿病、高血压对运动耐量产生负面影响，动脉粥样硬化型患者比非冠脉粥样硬化患者的运动耐量更好。此外，年龄和BMI与运动耐量相对水平呈负相关，但去掉年龄、性别因素后，BMI与运动耐量VO2max%呈正相关。后续研究可采用队列研究进一步验证康复运动和运动耐量之间的关系，并探究营养、心理、睡眠等对于运动耐量的长期影响，也可采用VO2max的衍生指标作为因变量进行研究。

Abstract:

      Abstract Objective： This survey aims to investigate exercise tolerance in the long term among patients with coronary heart disease after percutaneous coronary intervention (PCI)， and to explore its influencing factors. Method： This is a retrospective study. The sample comes from 1160 patients with coronary heart disease and PCI intervention who had been taking regular cardiopulmonary exercise testing at the physical examination center from September 2017 to March 2021. Result： Sex， education， post-PCI time， hypertension， diabetes， work mental stress， work physical consumption and calcium antagonist had significant effects on the relative value of maximal oxygen uptake(VO2max) (P<0.05). Sex， education， post-PCI time， atherosclerosis， diabetes， smoking， and housework had significant effects on VO2max% (P<0.05). Age and BMI were significantly correlated with VO2max. Conclusion： Patients who had undergone more years after PCI showed better exercise tolerance. Women had better exercise tolerance than men. Education， housework， and exercise degree had a positive effect on exercise tolerance. Smoking， diabetes， or high blood pressure harmed exercise tolerance. Patients with atherosclerosis performed better than patients without coronary atherosclerosis. In addition， age and BMI were negatively correlated with the relative level of exercise tolerance. However, after removing the influence of sex and age， BMI was positively correlated with VO2max%. Future cohort studies could verify the causality and explore the long-term effects of nutrition， psychology， sleep etc. In addition， researchers may use the derivative indexes of VO2max as the dependent variable for research.