6分钟步行试验在稳定性冠心病患者社区心脏康复中的应用

杨玲; 杜雪平

doi:10.16766/j.cnki.issn.1674-4152.003122

6分钟步行试验在稳定性冠心病患者社区心脏康复中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003122

杨玲^,,
杜雪平

首都医科大学附属复兴医院月坛社区卫生服务中心全科医学科，北京 100045

基金项目:

首都卫生发展科研专项首发2018-3-7023

详细信息

通讯作者:
杨玲, E-mail: yangling_1212@ccmu.edu.cn

中图分类号: R541.4
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- 被引次数: 0
出版历程
- 收稿日期: 2023-02-12

Application of 6-minute walk test in community-based cardiac rehabilitation of patients with stable coronary artery disease

YANG Ling^,,
DU Xueping

Department of General Practice, Yuetan Community Health Service Center, Fuxing Hospital, Capital Medical University, Beijing 100045, China

摘要

摘要: 目的通过分析稳定性冠心病患者运动康复前后6分钟步行距离(6MWD)变化，评估运动康复效果。方法 2021年6月—2022年6月从月坛社区卫生服务中心规范管理的、75岁以下稳定性冠心病患者中招募试验组和对照组各50例，试验组采用功率自行车进行运动康复，每例受试者蹬功率自行车总计30次，每次20 min，每周3~5次，对照组为散步等低强度运动，每次30~60 min，每周3~5次。观察指标为干预前后的6MWD，采用χ²检验对试验组和对照组干预前后效果进行评价。结果按6MWD对应的心肺功能分级，“≤300 m”为“1~2级”，“≥301 m”为“3~4级”。试验组和对照组干预后心肺功能分级比较，差异有统计学意义(χ²=21.951，P < 0.001)。将试验组、对照组干预前后6MWD增长(Δ6MWD)分组为“ < 54 m”和“≥54 m”，试验组、对照组Δ6MWD分级比较，差异有统计学意义(χ²=96.078，P < 0.001)。结论稳定性冠心病患者使用功率自行车运动康复后6MWD增加，心肺功能分级提高，可为今后冠心病患者社区心脏康复提供重要参考。
- 心脏康复 /
- 6分钟步行试验 /
- 稳定性冠心病患者
Abstract: Objective To evaluate the effect of exercise rehabilitation by analyzing the 6-minute walking distance (6MWD) of patients with stable coronary artery disease before and after exercise rehabilitation. Methods Fifty patients in the experimental group and 50 patients in the control group were recruited from patients with stable coronary artery disease under the age of 75 years under standard management from June 2021 to June 2022 of the Yuetan Community Health Service Center. The experimental group underwent exercise rehabilitation, which consisted of exercise bicycle training. Each subject pedaled an exercise of bicycle for 30 times, 20 minutes each time, 3-5 times a week. The control group used low-intensity exercise such as walking, 3-5 times a week, 30-60 minutes each time. The observation index was 6MWD before and after intervention. The effects of the experimental group and the control group before and after intervention were evaluated by chi-square test. Results According to the cardiopulmonary function classification corresponding to 6MWD, "≤300 m" was "Level 1 to 2" and "≥301 m" was "Level 3 to 4". There was a statistically significant difference in cardiopulmonary function grading between the experimental group and the control group after intervention (χ²=21.951, P < 0.001). The increase of 6MWD (Δ6MWD) before and after the intervention were grouped as " < 54 m" and "≥54 m" in the experimental and control groups, and the difference was statistically significant when comparing the Δ6MWD grading in the test and control groups (χ²=96.078, P < 0.001). Conclusion The 6MWD and cardiopulmonary function grading of patients with stable coronary artery disease were increased after exercise rehabilitation with an exercise bicycle, which may provide an important reference for community cardiac rehabilitation of patients with coronary artery disease in the future.
- Cardiac rehabilitation /
- 6-minute walk test /
- Patients with stable coronary artery disease
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表 1 2组稳定性冠心病患者一般情况比较[例(%)]

Table 1. Comparison of the general situation of patients with stable coronary heart disease in 2 groups[cases(%)]

项目	试验组 (n=50)	对照组 (n=50)	χ²值	P值
性别			1.033	0.309
男性	27(54.00)	32(64.00)
女性	23(46.00)	18(36.00)
年龄			0.043	0.836
< 65岁	18(36.00)	19(38.00)
≥65岁	32(64.00)	31(62.00)
PCI			2.154	0.142
是	21(42.00)	14(28.00)
否	29(58.00)	36(72.00)
糖尿病			0.162	0.687
是	21(42.00)	23(46.00)
否	29(58.00)	27(54.00)
高尿酸血症			1.778	0.182
是	3(6.00)	7(14.00)
否	47(94.00)	43(86.00)
血压达标			< 0.001	1.000
是	47(94.00)	47(94.00)
否	3(6.00)	3(6.00)
规律运动			1.000	0.317
是	42(84.00)	38(72.00)
否	8(16.00)	12(24.00)
运动强度			0.638	0.424
≤7 METs	40(80.00)	43(86.00)
>7 METs	10(20.00)	7(14.00)

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表 2 2组稳定性冠心病患者干预后心肺功能分级比较[例(%)]

Table 2. Comparison of cardiopulmonary function in 2 groups of patients with stable coronary heart disease after intervention[cases(%)]

组别	例数	干预前		干预后
组别	例数	1~2级	3~4级	1~2级	3~4级
试验组	50	23(46.00)	27(54.00)	0	50(100.00)
对照组	50	23(46.00)	27(54.00)	18(36.00)	32(64.00)
χ²值		< 0.001		21.951
P值		1.000		< 0.001

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