| 摘要: |
| ［摘要］ 目的 探究心肺康复训练配合增强型体外反搏（EECP）对慢性阻塞性肺疾病（COPD）合并非高危稳定型心绞痛患者心肺储备功能、血管内皮功能及运动能力的影响。方法 选取2020年1月至2022年6月首都医科大学附属北京康复医院收治的COPD合并非高危稳定型心绞痛患者80例，随机分为对照组（n=40）和观察组（n=40）。对照组患者接受基础治疗以及心肺康复训练；观察组在对照组干预措施的基础上加用EECP干预。两组均连续干预5周。比较两组患者心肺储备功能、血管内皮功能、运动能力、心绞痛发作情况及生存质量。结果 干预后，两组第1秒用力呼气容积/用力肺活量（FEV1/FVC）、最大通气量（MVV）和左心室射血分数（LVEF）均显著升高（P<0.05），且观察组显著高于对照组（P<0.05）。干预后，两组一氧化氮（NO）水平显著升高（P<0.05），血管内皮素-1（ET-1）和内皮细胞特异分子-1（ESM-1）水平显著降低（P<0.05）；且观察组NO水平显著高于对照组（P<0.05），ET-1和ESM-1水平显著低于对照组（P<0.05）。干预后，两组总运动时间、运动耐量及ST段压低0.1 mV时间显著升高（P<0.05），ST段下移幅度显著降低（P<0.05）；且观察组总运动时间、运动耐量和ST段压低0.1 mV时间显著高于对照组（P<0.05），ST段下移幅度显著低于对照组（P<0.05）。干预后，两组心绞痛发作频率、发作程度显著降低（P<0.05），西雅图心绞痛调查量表（SAQ）评分显著升高（P<0.05）；且观察组心绞痛发作频率、发作程度显著低于对照组（P<0.05），SAQ评分显著高于对照组（P<0.05）。干预后，两组生存质量测定量表（WHOQOL-BREF）生理维度和心理维度评分显著升高（P<0.05），且观察组显著高于对照组（P<0.05），但环境维度和社会关系维度评分无明显变化（P>0.05）。结论 心肺康复训练配合EECP可有效改善COPD合并非高危稳定型心绞痛患者心肺储备功能、血管内皮功能及运动能力，减轻心绞痛发作情况，提高生存质量。 |
| 关键词: 慢性阻塞性肺疾病 非高危稳定型心绞痛 增强型体外反搏 心肺储备功能 血管内皮功能 运动能力 |
| DOI：10.3969/j.issn.1674-3806.2024.12.12 |
| 分类号:R 541.4 |
| 基金项目:首都医科大学附属北京康复医院科研发展专项康复临床研究培育专项青年项目（编号：2021-036） |
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| Application effect of cardiopulmonary rehabilitation training combined with enhanced external counterpulsation in COPD patients complicated with non-high-risk stable angina pectoris |
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SUN Xiaojing, WANG Lizhong, ZHANG Zhenying, ZHANG Liu, XU Zhiping, YANG Cheng
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Cardiac Rehabilitation Center, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China
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| Abstract: |
| ［Abstract］ Objective To explore the effects of cardiopulmonary rehabilitation training combined with enhanced external counterpulsation(EECP) on cardiopulmonary reserve function, vascular endothelial function and athletic ability in chronic obstructive pulmonary disease(COPD) patients complicated with non-high-risk stable angina pectoris. Methods A total of 80 COPD patients complicated with non-high-risk stable angina pectoris who were admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from January 2020 to June 2022 were selected and randomly divided into control group(n=40) and observation group(n=40). The control group received basic treatment and cardiopulmonary rehabilitation training, while the observation group was supplemented with EECP intervention on the basis of the intervention in the control group. Both groups were treated for 5 weeks. The cardiopulmonary reserve function, vascular endothelial function, athletic ability, angina attack and quality of life were compared between the two groups. Results After intervention, forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC), maximal voluntary ventilation(MVV) and left ventricular ejection fraction(LVEF) in both groups were significantly elevated(P<0.05), and these indicators in the observation group were higher than those in the control group(P<0.05). After intervention, the levels of nitric oxide(NO) were significantly increased(P<0.05), while the levels of endothelin-1(ET-1) and endothelial cell-specific molecule-1(ESM-1) were significantly decreased in both groups(P<0.05), and the level of NO in the observation group was significantly higher than that in the control group(P<0.05), and the levels of ET-1 and ESM-1 in the observation group were significantly lower than those in the control group(P<0.05). After intervention, the total exercise time, the exercise tolerance and the spending time of ST segment depression by 0.1 mV were elevated, while the downward amplitude of ST segment was significantly decreased in both groups(P<0.05), and the total exercise time, the exercise tolerance and the spending time of ST segment depression by 0.1 mV in the observation group were significantly higher than those in the control group(P<0.05), and the downward amplitude of ST segment in the observation group was lower than that in the control group(P<0.05). After intervention, the frequency and intensity of angina attacks were significantly decreased(P<0.05), and the scores of Seattle Angina Questionnaire(SAQ) scale were significantly increased in both groups(P<0.05), and the frequency and intensity of angina attacks in the observation group were significantly lower than those in the control group(P<0.05), and the SAQ scores in the observation group were significantly higher than those in the control group(P<0.05). After intervention, the scores of World Health Organization Quality of Life-BREF(WHOQOL-BREF) in physiological and psychological fields were significantly decreased in both groups(P<0.05), and the scores of WHOQOL-BREF in the observation group were significantly higher than those in the control group(P<0.05), but there was no significant change in the scores of environmental and social relations fields(P>0.05). Conclusion Cardiopulmonary rehabilitation training combined with EECP can effectively improve cardiopulmonary reserve function, vascular endothelial function and athletic ability in COPD patients complicated with non-high-risk stable angina pectoris, and alleviate angina attack and improve quality of life. |
| Key words: Chronic obstructive pulmonary disease(COPD) Non-high-risk stable angina pectoris Enhanced external counterpulsation(EECP) Cardiopulmonary reserve function Vascular endothelial function Athletic ability |
