康复训练对冠心病患者介入治疗后的运动耐量的影响

目的 察康复训练对冠心病经皮冠状动脉介入治疗（PCI）后患者运动耐量的影响。方法 确诊为冠心病并成功进行了首次PCI的患者57例，随机分为运动康复组（26例）和对照组（31例）．2组患者除行PCI治疗外，均采用相似的常规疗法（口服肠溶阿司匹林、硝酸酯类、转换酶抑制剂或他汀类药物等）。运动康复组于PCI术后第3天开始进行不同阶段、不同运动强度的康复训练，运动分为热身期，锻炼期、恢复期。3个月后，行心电图活动平板运动试验。观察活动平板运动试验运动前、运动中的心率、血压、心电图改变及心绞痛发作情况。结果 运动康复治疗3个月后，运动康复组与对照组静息及运动时心率、收缩压、舒张压、心率-血压双乘积差异无统计学意义（P〉0．05），其总运动时间、运动至出现S段压低1mm时间、运动至心绞痛出现时间与对照组相比明显延长（P〈0．05或P〈0．01），最大运动耐量明显增加（P〈0．05或P〈0．01）。结论 照运动处方进行的运动训练能明显缓解冠心病介入治疗后患者心绞痛症状及改善心电图缺血性S—T变化，提高冠心病介入治疗后患者的运动耐量，延长运动时间。

Effects of rehabilitation training on exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention

Objective To study the effects of rehabilitation training on the exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention. Methods Fifty-sever cases of coronary heart disease after percutaneous coronary intervention were given routine medical treatment and divided randomly into a rehabilitation training group (26 cases) and a control group (31 cases). Patients in the rehabilitation training group started staged rehabilitation training of increasing intensity 3 days after percutaneous coronary intervention, and continued for a period of 3 months. Their heart rate, blood pressure, changes in ECG during treadmill exercise, as well as the frequency of any angina episodes were observed. Results The results showed that rehabilitation training could not only prolong the patients' total exercise time, the latency of ST segment depression and the incidence of exercise-induced angina, but also improve their exercise tolerance ( P < 0. 05 , or 0.01). However, the heart rate and blood pressure before and after exercise were similar in both groups. Conclusion Rehabilitation training could significantly relieve angina, improve ischemia's ECG manifestations and increase the exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention.