| ObjectiveTo understand the effects of exercise training under the guidance of exercise prescription made by cardiopulmonary exercise test and trimetazidine on exercise tolerance and cardiac function in patients with coronary heart disease after PCI,and to explore whether the effect of the combination of them is more significant.MethodsFrom January 2018 to June 2019,127 patients with coronary heart disease who were hospitalized in the Department of Cardiology,Fuwai Central China Cardiovascular Hospital,were divided into trimetazidine + rehabilitation group,rehabilitation group,trimetazidine group and control group.Four groups of patients were given standard drug treatment for secondary prevention of coronary heart disease,and one group(trimetazidine + rehabilitation group)was given oral trimetazidine of 20 mg three times a day,and received exercise training under the guidance of exercise prescription.One group(rehabilitation group)completed exercise training under the guidance of exercise prescription.One group(trimetazidine gr oup)was given 20 mg trimetazidine orally three times a day.One group(control group)received neither exercise training under the guidance of exercise prescription nor oral trimetazidine.All patients were enrolled in the cardiac rehabilitation clinic,an d then their cardiovascular and motor abilities were evaluated,and a structured exercise prescription was made.After 6 months of intervention,the rehabilitation of the four groups was evaluated before and after intervention.(1)the changes of BMI,anae robic threshold,peak oxygen uptake,Δ VO2/ Δ WR,peak METs,peak oxygen pulse,peak power and HRR before and after treatment were analyzed,and the differences of indexes between groups were compared;(2)the changes of weber grade of cardiac function bef ore and after treatment were analyzed,and the differences between groups were compared.Results(1)body mass index: There was no significant difference in baseline BMI among the four groups(P > 0.05).After 6 months of intervention,the BMI indexes in th e four groups decreased,and the indexes in the trimetazidine + rehabilitation group and the rehabilitation group were significantly lower than those in the baseline and the same period control group and trimetazidine group(P< 0.05).There was no signific ant difference between trimetazidine group and baseline and control group(P > 0.05).(2)exercise endurance: compared with 6 months after intervention,the anaerobic threshold,peak oxygen uptake,peak oxygen pulse,peak METs and peak power in the trimeta zidine + exercise group were significantly increased,and HRR was significantly decreased,while the above-mentioned indexes were significantly improved in the exercise group and trimetazidine group.In the control group,the anaerobic threshold,peak oxyg en uptake,peak oxygen pulse,peak METs and peak power were also improved,and HRR was also decreased to a certain extent,P>0.05,and there was no significant difference among the four groups at enrollment and 6 months after intervention: Δ VO2/ ΔWR,P > 0.05,the difference was not statistically significant.The changes of various indexes before and after treatment in the four groups were as follows: anaerobic threshold,peak oxygen uptake,peak oxygen pulse,peak METs,peak power,HRR calculated differenc e at the time of enrollment and 6 months after intervention,Δ anaerobic threshold,Δ peak oxygen uptake,Δ peak oxygen pulse,Δ peak METs,Δ peak power,Δ HRR,were calculated as Δ anaerobic threshold,Δ peak oxygen uptake,Δ peak oxygen pulse,Δ peak oxy gen uptake,Δ peak oxygen pulse,Δ peak METs,Δ peak power,Δ peak oxygen pulse.There were also significant differences in Δ anaerobic threshold,Δ peak oxygen uptake,Δ peak oxygen pulse,Δ peak METs and Δ peak power among the four groups,but there was no significant difference in Δ HRR(P > 0.05).The results of further pairwise comparison of statistically significant indexes showed that the anaerobic threshold,peak oxygen uptake,peak METs,peak oxygen pulse and peak power in the trimetazidine + rehab ilitation group,the rehabilitation group and the trimetazidine group were all higher than those in the control group,and the above-mentioned indexes in the trimetazidine + rehabilitation group were better than those in the rehabilitation group and trimet azidine group(P < 0.05).The above-mentioned indexes in the rehabilitation group were not significantly better than those in the trimetazidine group(P > 0.05),and the difference was not statistically significant.(3)Cardiac function: Before interventio n,there was no significant difference in the grade of cardiac function in the control group.after intervention,the improvement of cardiac function in the trimetazidine + rehabilitation group,the rehabilitation group and the trimetazidine group was more signifi cant than that in the control group(P < 0.05).Conclusion(1)exercise training can reduce the body weight of patients with coronary heart disease after PCI,so as to better manage the risk factors of patients with coronary heart disease and make patients return to life better.(2)both exercise training and tri metazidine can effectively improve the exercise endurance of patients with coronary heart disease after PCI,and the combination of exercise training and trimetazidine can improve exercise ability more significantly.(3)in terms of the improvement of card iac function,trimetazidine and exerci se rehabilitation alone or in combination can improve cardiac function. |
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