增强型体外反搏联合中强度间歇训练对冠心病心肺储备能力及运动耐力的影响

关键词：增强型体外反搏  中强度间歇训练  心肺运动试验  心脏储备能力  肺脏储备能力  运动耐力

Keywords:enhanced external counterpulsation  moderate-intensity interval training  cardiopulmonary exercise test  cardiac reserve capacity  pulmonary reserve capacity  exercise endurance

摘要：

      摘要 目的：探讨增强型体外反搏（EECP）联合中强度间歇训练（MIIT）对冠心病患者心肺储备功能及运动耐力的影响。 方法：选取2021年6月—2022年6月在河北医科大学第一医院心血管内科和康复科住院或门诊冠心病患者60例，随机分为对照组30例，治疗组30例。两组均给予冠心病二级预防用药，对照组给予常规中强度间歇训练（MIIT），治疗组在对照组的基础上加用增强型体外反搏治疗。观察两组治疗前后的心脏储备指标：左室射血分数（LVEF）、左室收缩末期容积（LVESV）、每搏量（SV）。肺脏储备指标：第一秒用力呼气容积（FEV1）、用力肺活量（FVC）、最大呼气流量（PEF）、潮气量（VT）。运动耐力指标：峰值摄氧量（PeakVO2）、无氧阈（AT）、峰值代谢当量（METs）、峰值氧脉搏（VO2/HR）、峰值负荷功率（WR）、6min步行（6MWT）距离。 结果：心脏储备指标：两组治疗后LVEF、LVESV、SV均有所改善，且治疗组在LVESV、SV方面优于对照组，具有显著性意义（P<0.05），两组LVEF治疗后无显著性差异（P＞0.05）。肺脏储备指标：两组治疗后FEV1、FVC、PEF、VT均有所改善，具有显著性意义（P<0.05），上述指标两组治疗后无显著性差异（P＞0.05）。运动耐力指标：两组治疗后PeakVO2、AT、METs、VO2/HR、WR、6MWT距离均有所改善，具有显著性意义（P<0.05），且治疗组优于对照组，具有显著性意义（P<0.05）。 结论：增强型体外反搏联合中强度间歇训练在改善冠心病患者心功能、运动耐力方面优于单纯中强度间歇训练，在改善肺功能方面无明显差别。

Abstract:

      Abstract Objective： To investigate the effects of enhanced external counterpulsation （EECP） combined with moderate-intensity interval training （MIIT） on cardiopulmonary reserve capacity and exercise endurance in patients with coronary artery disease. Method： Sixty patients with coronary heart disease who were hospitalized or outpatients in the Department of Cardiovascular Medicine or Department or Rehabilitation Medicine of the First Hospital of Hebei Medical University from June 2021 to June 2022 were selected and randomly divided into the control group and the treatment group，30 cases in each group. Both groups were given drugs for secondary prevention of coronary heart disease. In addition， the control group was given moderate-intensity interval training （MIIT）， and the treatment group was treated with enhanced external counterpulsation （EECP） on the basis of the control group. The cardiac reserve indexes： left ventricular ejection fraction （LVEF）， left ventricular end-systolic volume （LVESV）， and volume per beat （SV） were observed before and after treatment in both groups. Pulmonary reserve indexes： first second force expiratory volume （FEV1）， force spirometry （FVC）， maximum expiratory flow （PEF）， tidal volume （VT）. Exercise endurance indexes： peak oxygen uptake （PeakVO2）， anaerobic threshold （AT）， peak metabolic equivalents （METs）， peak oxygen pulse （VO2/HR）， peak loading power （WR）， Six-minute walk （6MWT） distance. Result： Cardiac reserve indexes： LVEF， LVESV， and SV improved in both groups after treatment， and the treatment group was better than the control group in LVESV and SV with statistical significance （P<0.05）， while there was no significant difference between the two groups in LVEF with no statistical significance （P>0.05）. Pulmonary reserve index： FEV1， FVC， PEF and VT improved before and after treatment in both groups with statistical significance （P<0.05）， while there was no significant difference between the two groups with no statistical significance （P>0.05）. Exercise endurance indexes： PeakVO2， AT， METs， VO2/HR， WR， 6MWT distance improved in both groups after treatment， with statistical significance （P<0.05）， and the treatment group showed more obvious improvement than the control group（P<0.05）. Conclusion： Enhanced external counterpulsation combined with moderate-intensity interval training was superior to moderate-intensity interval training alone in improving cardiac function and exercise endurance in patients with coronary artery disease， and there was no significant difference in improving pulmonary function.