目的 探讨不同训练强度对接受经皮冠状动脉介入治疗术（PCI）后冠心病患者心肺功能的影响。方法 选择2020年7月—2022年2月住院的冠心病并成功进行PCI患者100例。按随机数字表法分为对照组和研究组,每组各50例。对照组（中等强度持续训练）以40%~59%的最大摄氧量（VO2）或55%~69%最大心率作为训练运动负荷;研究组（高强度间歇训练）以>80%最大VO2或85%~95%最大心率作为训练运动负荷。两组患者每次踩功率车时间共30 min,每周训练3次,连续4周,两组均给予常规的药物治疗。所有患者康复前后均行心脏彩超检查及心肺运动试验（CPET）评估患者心肺功能及运动耐力。结果 两组患者年龄、性别、既往疾病方面无显著差异。康复前,研究组与对照组两组患者的左室射血分数（LVEF）、无氧阈时摄氧量（VO2 AT）、峰值摄氧量（peak VO2）、氧脉搏、二氧化碳通气当量（VE/VCO2）斜率无显著差异。康复后,VO2 AT、peak VO2、氧脉搏、每分通气量（VE）这四个指标较康复前的改变值在研究组明显高于对照组,差异具有统计学差异（P<0.05）。Spearman相关分析显示,VO2 AT、peak VO2、氧脉搏、VE的改变值与运动强度呈正相关,差异具有统计学意义（P<0.05）。结论 与中等强度持续有氧运动相比,高强度间歇有氧运动可以更好地改善PCI术后冠心病患者的有氧代谢能力,提高患者的运动耐力。
Objective To investigate the effects of different training intensities on cardiopulmonary function in patients with coronary heart disease after percutaneous coronary intervention （PCI）. Methods A total of 100 patients with coronary heart disease who were hopitalized from July 2020 to February 2022 and successfully underwent PCI were selected and divided into a control group （50 cases） and a study group （50 cases） by random number table method. The control group （moderate intensity continuous training） had a maximum oxygen uptake （VO2） of 40% to 59% or a maximum heart rate of 55% to 69% as the training load, while the study group （high intensity interval training） had a maximum VO2 of >80% or a maximum heart rate of 85% to 95% as the training load. The two groups of patients exercised on an ergometer for 30 min per time, 3 times a week, for 4 consecutive weeks, and received conventional drug treatment. All patients underwent cardiac ultrasound and cardiopulmonary exercise test （CPET） before and after rehabilitation to evaluate cardiopulmonary function and exercise endurance. Results There were no significant differences in age, sex, and history of diseases between the two groups. Before rehabilitation, there were no significant differences in left ventricular ejection fractions （LVEF）, oxygen uptake at anaerobic threshold （VO2 AT）, peak oxygen uptake （peak VO2）, oxygen pulse, and ventilatory equivalent for carbon dioxide （VE/VCO2） slope between the study group and the control group. The changes before and after rehabilitation in VO2 AT, peak VO2, oxygen pulse, and minute ventilation volume （VE） were significantly higher in the study group than in the control group （P<0.05）. Spearman correlation analysis showed that the change values of VO2 AT, peak VO2, oxygen pulse, and VE were positively correlated with training intensity （P<0.05）. Conclusions Compared with moderate intensity continuous aerobic exercise, high intensity interval aerobic exercise can better improve the aerobic metabolic capacity and exercise endurance of patients with coronary heart disease after PCI.
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