基于客观指标的不同强度运动康复对稳定型冠心病患者PCI术后的影响分析

Analysis of the effects of exercise rehabilitation with different intensities based on objective indicators on patients with stable coronary heart disease after PCI

摘要:

目的 探讨不同强度运动康复对稳定型冠心病患者经皮冠状动脉介入治疗（PCI）后的临床疗效。方法 选取2023年3月—2025年3月沧州市中心医院收治的107例PCI术后稳定型冠心病患者作为研究对象，采用随机数字表法分为对照组［54例，接受中等强度持续训练（MICT）］与观察组［53例，接受高强度间歇训练（HIIT）］。比较两组患者的运动功能指标［（峰值摄氧量（VO₂ peak）、无氧阈值（AT）、运动持续时间（ED）及峰值功率（PP）］、肺功能与耐力指标［最大自主通气量（MVV）、用力肺活量（FVC）、第一秒用力呼气容积（FEV₁）及6分钟步行试验距离（6MWT）］、心功能指标［左室射血分数（LVEF）、左室收缩末内径（LVESD）及左室舒张末内径（LVEDD）］、生化指标［氨基末端脑钠肽前体（NT-proBNP）、超敏C反应蛋白（hs-CRP）、内皮素-1（ET-1）］及特异性生活质量［西雅图心绞痛调查量表（Seattle Angina Questionnaire， SAQ）中的身体受限、心绞痛频率、心绞痛稳定性3项］。结果 观察组治疗前后VO₂ peak、AT、ED及PP的差值均大于对照组（P <0.05）。观察组治疗前后MVV、FVC、FEV₁及6MWT的差值均大于对照组（P <0.05）。观察组治疗前后LVEF、LVESD及LVEDD的差值均大于对照组（P <0.05）。观察组治疗前后NT-proBNP、hs-CRP及ET-1的差值均大于对照组（P <0.05）。观察组治疗前后身体受限、心绞痛频率、心绞痛稳定性评分的差值均大于对照组（P <0.05）。结论 HIIT较MICT能更显著改善PCI术后患者心肺功能、促进心脏逆向重构、降低神经内分泌激活及炎症水平，并有效提升生活质量，推荐临床推广应用。

Abstract:

Objective To investigate the clinical efficacy of exercise rehabilitation with different intensities in patients with stable coronary heart disease after percutaneous coronary intervention (PCI).Methods From March 2023 to March 2025, a total of 107 patients with stable coronary heart disease after PCI admitted to this hospital were enrolled. Using a random number table method, they were divided into a control group (n = 54), which received moderate-intensity continuous training (MICT), and an observation group (n = 53), which received high-intensity interval training (HIIT). Exercise capacity indices, pulmonary function and endurance parameters, cardiac function indicators, biochemical markers, and disease-specific quality of life were compared between the two groups.Results The changes in VO₂ peak, anaerobic threshold (AT), exercise duration (ED), and peak power (PP) were greater in the observation group than in the control group (P < 0.05). The improvements in maximal voluntary ventilation (MVV), forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and 6-minute walk test (6MWT) were also greater in the observation group (P < 0.05). The observation group showed more pronounced increases in left ventricular ejection fraction (LVEF) and greater reductions in left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) (P < 0.05). The decreases in N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and endothelin-1 (ET-1) were more significant in the observation group (P < 0.05). In addition, the change in Seattle Angina Questionnaire (SAQ) score was larger in the observation group than in the control group (P < 0.05).Conclusion Compared with MICT, HIIT more effectively enhances cardiopulmonary function, promotes reverse cardiac remodeling, reduces neuroendocrine activation and inflammatory responses, and improves quality of life in patients after PCI. HIIT is recommended for wider clinical application.