我国心脏康复发展历程及心脏运动康复研究进展
|
摘要
随着近年来医疗技术如经皮冠状动脉介入治疗、冠状动脉旁路移植术等的进步,我国冠心病患者病死率有所下降,但仍有部分冠心病患者经治疗后未能回归正常生活。心脏康复作为治疗心血管疾病的新模式,可通过全面精准管理和全程康复而有效提高冠心病患者心血管健康获益。本文综述了我国心脏康复的发展历程及心脏运动康复研究进展,以期为冠心病的有效防治提供参考。
With the development of clinical medical technology(such as PCI and CABG)in recent years,the mortality of patients with coronary heart disease significantly decreased,but some patients failed to return to normal life even after treatment. Cardiac rehabilitation(CR),as an innovative treatment model for cardiovascular disease,can effectively improve the cardiovascular health benefits of coronary heart disease patients through comprehensive accurate management and full-course rehabilitation. This paper reviewed the development history of cardiac rehabilitation in China and research progress for cardiac exercise rehabilitation,in order to provide a reference for the effective preventive and treatment of coronary heart disease.
With the development of clinical medical technology(such as PCI and CABG)in recent years,the mortality of patients with coronary heart disease significantly decreased,but some patients failed to return to normal life even after treatment. Cardiac rehabilitation(CR),as an innovative treatment model for cardiovascular disease,can effectively improve the cardiovascular health benefits of coronary heart disease patients through comprehensive accurate management and full-course rehabilitation. This paper reviewed the development history of cardiac rehabilitation in China and research progress for cardiac exercise rehabilitation,in order to provide a reference for the effective preventive and treatment of coronary heart disease.
引文
[1]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要[J].中国循环杂志,2018,33(1):1-8.
[2]KWOK C S,KHAN M A,RAO S V,et al.Access and nonaccess site bleeding after percutaneous coronary intervention and risk of subsequent mortality and major adverse cardiovascular events:systematic review and meta-analysis[J].Circ Cardiovasc Interv,2015,8(4):e001645.DOI:10.1161/CIRCINTERVENTIONS.114.001645.
[3]陈纪言,陈韵岱,韩雅玲.经皮冠状动脉介入治疗术后运动康复专家共识[J].中国介入心脏病学杂志,2016,24(7):361-369.DOI:10.3969/j.issn.1004-8812.2016.07.001.
[4]马云飞,王洪娟,王俊峰,等.急性心肌梗死患者PCI术后的心脏康复现状及进展[J].中国老年学杂志,2017,37(7):1778-1779.DOI:10.3969/j.issn.1005-9202.2017.07.091.
[5]刘佳妮,徐峰.心脏康复运动指导对ACS患者介入术后生活质量的影响[J].心血管康复医学杂志,2017,26(6):581-586.DOI:10.3969/j.issn.1008-0074.2017.06.01.
[6]蒲静,王秋林,王沛坚,等.运动训练对女性急性心肌梗死患者经皮冠状动脉介入治疗后预后的影响[J].实用心脑肺血管病杂志,2017(12):109-113.DOI:10.3969/j.issn.1008-5971.2017.12.029.
[7]钱毅东.综合心脏康复治疗对冠状动脉硬化性心脏病介入术后患者的效果[J].中西医结合心血管病电子杂志,2017,5(27):40.DOI:10.3969/j.issn.2095-6681.2017.27.029.
[8]常秀群,孔永梅,姜芳荣,等.运动康复模式对糖尿病患者糖脂代谢及生活质量的影响[J].慢性病学杂志,2017,18(10):1089-1092.
[9]陆晓.心脏康复的演变与进展[J].中国康复医学杂志,2017,32(1):4-9.DOI:10.3969/j.issn.1001-1242.2017.01.003.
[10]国家心血管病中心《中西医结合I期心脏康复专家共识》专家委员会.中西医结合Ⅰ期心脏康复共识[J].中华高血压杂志,2017,25(12):1140-1148.DOI:10.16439/j.cnki.1673-7245.2017.12.018.
[11]中华医学会心血管病学分会,中国康复医学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会.冠心病康复与二级预防中国专家共识[J].中华心血管病杂志,2013,41(4):267-275.DOI:10.3760/cma.j.issn.0253-3758.2013.04.003.
[12]中国康复学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会.在心血管科就诊患者的心理处方中国专家共识[J].中华心血管病杂志,2014,42(1):6-13.DOI:10.3760/cma.j.issn.0253-3758.2014.01.003.
[13]中华医学会心血管病学分会预防学组,中国康复医学会心血管病专业委员会.冠心病患者运动治疗中国专家共识[J].中华心血管病杂志,2015,43(7):575-588.DOI:10.3760/cma.j.issn.0253-3758.2015.07.004.
[14]丁荣晶,胡大一.中国心脏康复服务发展不均衡,未来心脏康复发展潜力巨大[R/OL].(2018-03-13)[2018-09-01].http://acc2018.icirculation.com/newsview-32349-310-0.html.
[15]GUO Y,LEDESMA R A,PENG R,et al.The Beneficial Effects of Cardiac Rehabilitation on the Function and Levels of Endothelial Progenitor Cells[J].Heart Lung Circ,2016,26(1):10-17.DOI:10.1016/j.hlc.2016.06.1210.
[16]孔明涯,陆晓,林松,等.生理性缺血训练对动脉粥样硬化进程中兔血管内皮的影响[J].中国康复医学杂志,2017,32(1):10-14.DOI:10.3969/j.issn.1001-1242.2017.01.004.
[17]ZHAO Y,LI J,LIN A,et al.Improving angiogenesis and muscle performance in the ischemic limb model by physiological ischemic training in rabbits[J].Am J Phys Med Rehabil,2011,90(12):1020-1029.DOI:10.1097/phm.0b013e318238a166.
[18]曹克勇,李雪芹,祝腊香,等.不同强度有氧运动对男性老年人骨密度和体成分的影响[J].中国康复,2016,31(2):91-93.DOI:10.3870/zgkf.2016.02.003.
[19]GAYDA M,RIBEIRO P A,JUNEAU M,et al.Comparison of Different Forms of Exercise Training in Patients With Cardiac Disease:Where Does High-Intensity Interval Training Fit?[J].Can J Cardiol,2016,32(4):485-494.DOI:10.1016/j.cjca.2016.01.017.
[20]LIOU K,HO S,FILDES J,et al.High Intensity Interval versus Moderate Intensity Continuous Training in Patients with Coronary Artery Disease:A Meta-analysis of Physiological and Clinical Parameters[J].Heart Lung Circ,2016,25(2):166-174.DOI:10.1016/j.hlc.2015.06.828.
[21]MEYER P,GAYDA M,JUNEAU M,et al.High-intensity aerobic interval exercise in chronic heart failure[J].Curr Heart Fail Rep,2013,10(2):130-138.DOI:10.1007/s11897-013-0130-3.
[22]JAUREGUIZAR K V,VICENTE-CAMPOS D,BAUTISTA L R,et al.Effect of High-Intensity Interval Versus Continuous Exercise Training on Functional Capacity and Quality of Life in Patients With Coronary Artery Disease:A RANDOMIZED CLINICAL TRIAL[J].J Cardiopulm Rehabil Prev,2016,36(2):96-105.DOI:10.1097/HCR.0000000000000156.
[23]VILLELABEITIA-JAUREGUIZAR K,VICENTE-CAMPOSD,SENEN A B,et al.Effects of high-intensity interval versus continuous exercise training on post-exercise heart rate recovery in coronary heart-disease patients[J].Int J Cardiol,2017,244:17-23.DOI:10.1016/j.ijcard.2017.06.067.
[24]MUNK P S,BRELAND U M,AUKRUST P,et al.High intensity interval training reduces systemic inflammation in post-PCI patients[J].Eur J Cardiovasc Prev Rehabil,2011,18(6):850-857.DOI:10.1177/1741826710397600.
[25]HANNAN A L,HING W,SIMAS V,et al.High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation:a systematic review and meta-analysis[J].Open Access J Sports Med,2018,9:1-17.DOI:10.2147/OAJSM.S150596.
[26]TSCHENTSCHER M,EICHINGER J,EGGER A,et al.Highintensity interval training is not superior to other forms of endurance training during cardiac rehabilitation[J].Eur J Prev Cardiol,2016,23(1):14-20.DOI:10.1177/2047487314560100.
[27]GOMESNETO M,DUR?ES A R,REIS H F C D,et al.Highintensity interval training versus moderate-intensity continuous training on exercise capacity and quality of life in patients with coronary artery disease:A systematic review and meta-analysis[J].Eur J Prev Cardiol,2017,24(16):1696-1707.DOI:10.1177/2047487317728370.
[28]SOROFF H S,HUI J,GIRON F.Current status of external counterpulsation[J].Crit Care Clin,1986,2(2):277-295.
[29]Task Force Members,MONTALESCOT G,SECHTEM U,et al.2013 ESC guidelines on the management of stable coronary artery disease:the Task Force on the management of stable coronary artery disease of the European Society of Cardiology[J].Eur Heart J,2013,34(38):2949-3003.DOI:10.1093/eurheartj/eht296.
[30]国际体外反搏学会,中国康复医学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会.心血管疾病康复处方--增强型体外反搏应用国际专家共识[J].中华内科杂志,2014,53(7):587-590.DOI:10.3760/cma.j.issn.0578-1426.2014.07.024.
[31]SARDARI A,HOSSEINI S K,BOZORGI A,et al.Effects of enhanced external counterpulsation on heart rate recovery in patients with coronary artery disease[J].J Tehran Heart Cent,2018,13(1):13-17.
[32]RAZA A,STEINBERG K,TARTAGLIA J,et al.Enhanced External Counterpulsation Therapy:Past,Present,and Future[J].Cardiol Rev,2017,25(2):59-67.DOI:10.1097/CRD.0000000000000122.
[33]肖永莉,李兴国,刘品,等.体外反搏治疗冠状动脉粥样硬化性心脏病的疗效观察[J].中国循证心血管医学杂志,2016,8(3):311-313.DOI:10.3969/j.issn.1674-4055.2016.03.15.
[34]孙刚,吴宇红,张学芳,等.增强型体外反搏对不稳定型心绞痛患者经皮冠状动脉介入治疗后血流的短期效应与安全性[J].岭南心血管病杂志,2018,24(1):9-13.DOI:10.3969/j.issn.1007-9688.2018.01.03.
[35]宋孟仙,刘华,王雯霞,等.体外心脏震波治疗对缺血性心力衰竭患者的疗效及其机制研究[J].临床心血管病杂志,2016,32(9):938-942.
[36]KAISER R A,LIANG Q,BUENO O,et al.Genetic Inhibition or Activation of JNK1/2 Protects the Myocardium from IschemiaReperfusion-induced Cell Death in Vivo[J].J Biol Chem,2005,280(38):32602-32608.DOI:10.1074/jbc.M500684200.
[37]YANG W,YAN H,GAN L,et al.Cardiac shock wave therapy promotes arteriogenesis of coronary micrangium,and ILK is involved in the biomechanical effects by proteomic analysis[J].Sci Rep,2018,8(1):1814.DOI:10.1038/s41598-018-19393-z.
[38]YU W,SHEN T,LIU B,et al.Cardiac shock wave therapy attenuates H9c2 myoblast apoptosis by activating the AKT signal pathway[J].Cell Physiol Biochem,2014,33(5):1293-1303.DOI:10.1159/000358697.
[39]ZUOZIENE G,LEIBOWITZ D,CELUTKIENE J,et al.Multimodality imaging of myocardial revascularization using cardiac shock wave therapy[J].Int J Cardiol,2015,187:229-230.DOI:10.1016/j.ijcard.2015.03.306.
[40]NIRALA S,WANG Y,PENG Y Z,et al.Cardiac shock wave therapy shows better outcomes in the coronary artery disease patients in a long term[J].Eur Rev Med Pharmacol Sci,2016,20(2):330-338.
[41]LIU B,ZHANG Y,JIA N,et al.Study of the Safety of Extracorporeal Cardiac Shock Wave Therapy:Observation of the Ultrastructures in Myocardial Cells by Transmission Electron Microscopy[J].J Cardiovasc Pharmacol Ther,2017,23(1):79-88.DOI:10.1177/1074248417725877.
[42]刘伟静,沈建颖,朱梦云,等.体外心脏震波治疗顽固性心绞痛的有效性和安全性[J].上海医学,2017,40(4):206-209.
[43]AENGEVAEREN V L,MOSTERD A,BRABER T L,et al.Relationship Between Lifelong Exercise Volume and Coronary Atherosclerosis in Athletes[J].Circulation,2017,136(2):138-148.DOI:10.1161/CIRCULATIONAHA.117.027834.
[2]KWOK C S,KHAN M A,RAO S V,et al.Access and nonaccess site bleeding after percutaneous coronary intervention and risk of subsequent mortality and major adverse cardiovascular events:systematic review and meta-analysis[J].Circ Cardiovasc Interv,2015,8(4):e001645.DOI:10.1161/CIRCINTERVENTIONS.114.001645.
[3]陈纪言,陈韵岱,韩雅玲.经皮冠状动脉介入治疗术后运动康复专家共识[J].中国介入心脏病学杂志,2016,24(7):361-369.DOI:10.3969/j.issn.1004-8812.2016.07.001.
[4]马云飞,王洪娟,王俊峰,等.急性心肌梗死患者PCI术后的心脏康复现状及进展[J].中国老年学杂志,2017,37(7):1778-1779.DOI:10.3969/j.issn.1005-9202.2017.07.091.
[5]刘佳妮,徐峰.心脏康复运动指导对ACS患者介入术后生活质量的影响[J].心血管康复医学杂志,2017,26(6):581-586.DOI:10.3969/j.issn.1008-0074.2017.06.01.
[6]蒲静,王秋林,王沛坚,等.运动训练对女性急性心肌梗死患者经皮冠状动脉介入治疗后预后的影响[J].实用心脑肺血管病杂志,2017(12):109-113.DOI:10.3969/j.issn.1008-5971.2017.12.029.
[7]钱毅东.综合心脏康复治疗对冠状动脉硬化性心脏病介入术后患者的效果[J].中西医结合心血管病电子杂志,2017,5(27):40.DOI:10.3969/j.issn.2095-6681.2017.27.029.
[8]常秀群,孔永梅,姜芳荣,等.运动康复模式对糖尿病患者糖脂代谢及生活质量的影响[J].慢性病学杂志,2017,18(10):1089-1092.
[9]陆晓.心脏康复的演变与进展[J].中国康复医学杂志,2017,32(1):4-9.DOI:10.3969/j.issn.1001-1242.2017.01.003.
[10]国家心血管病中心《中西医结合I期心脏康复专家共识》专家委员会.中西医结合Ⅰ期心脏康复共识[J].中华高血压杂志,2017,25(12):1140-1148.DOI:10.16439/j.cnki.1673-7245.2017.12.018.
[11]中华医学会心血管病学分会,中国康复医学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会.冠心病康复与二级预防中国专家共识[J].中华心血管病杂志,2013,41(4):267-275.DOI:10.3760/cma.j.issn.0253-3758.2013.04.003.
[12]中国康复学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会.在心血管科就诊患者的心理处方中国专家共识[J].中华心血管病杂志,2014,42(1):6-13.DOI:10.3760/cma.j.issn.0253-3758.2014.01.003.
[13]中华医学会心血管病学分会预防学组,中国康复医学会心血管病专业委员会.冠心病患者运动治疗中国专家共识[J].中华心血管病杂志,2015,43(7):575-588.DOI:10.3760/cma.j.issn.0253-3758.2015.07.004.
[14]丁荣晶,胡大一.中国心脏康复服务发展不均衡,未来心脏康复发展潜力巨大[R/OL].(2018-03-13)[2018-09-01].http://acc2018.icirculation.com/newsview-32349-310-0.html.
[15]GUO Y,LEDESMA R A,PENG R,et al.The Beneficial Effects of Cardiac Rehabilitation on the Function and Levels of Endothelial Progenitor Cells[J].Heart Lung Circ,2016,26(1):10-17.DOI:10.1016/j.hlc.2016.06.1210.
[16]孔明涯,陆晓,林松,等.生理性缺血训练对动脉粥样硬化进程中兔血管内皮的影响[J].中国康复医学杂志,2017,32(1):10-14.DOI:10.3969/j.issn.1001-1242.2017.01.004.
[17]ZHAO Y,LI J,LIN A,et al.Improving angiogenesis and muscle performance in the ischemic limb model by physiological ischemic training in rabbits[J].Am J Phys Med Rehabil,2011,90(12):1020-1029.DOI:10.1097/phm.0b013e318238a166.
[18]曹克勇,李雪芹,祝腊香,等.不同强度有氧运动对男性老年人骨密度和体成分的影响[J].中国康复,2016,31(2):91-93.DOI:10.3870/zgkf.2016.02.003.
[19]GAYDA M,RIBEIRO P A,JUNEAU M,et al.Comparison of Different Forms of Exercise Training in Patients With Cardiac Disease:Where Does High-Intensity Interval Training Fit?[J].Can J Cardiol,2016,32(4):485-494.DOI:10.1016/j.cjca.2016.01.017.
[20]LIOU K,HO S,FILDES J,et al.High Intensity Interval versus Moderate Intensity Continuous Training in Patients with Coronary Artery Disease:A Meta-analysis of Physiological and Clinical Parameters[J].Heart Lung Circ,2016,25(2):166-174.DOI:10.1016/j.hlc.2015.06.828.
[21]MEYER P,GAYDA M,JUNEAU M,et al.High-intensity aerobic interval exercise in chronic heart failure[J].Curr Heart Fail Rep,2013,10(2):130-138.DOI:10.1007/s11897-013-0130-3.
[22]JAUREGUIZAR K V,VICENTE-CAMPOS D,BAUTISTA L R,et al.Effect of High-Intensity Interval Versus Continuous Exercise Training on Functional Capacity and Quality of Life in Patients With Coronary Artery Disease:A RANDOMIZED CLINICAL TRIAL[J].J Cardiopulm Rehabil Prev,2016,36(2):96-105.DOI:10.1097/HCR.0000000000000156.
[23]VILLELABEITIA-JAUREGUIZAR K,VICENTE-CAMPOSD,SENEN A B,et al.Effects of high-intensity interval versus continuous exercise training on post-exercise heart rate recovery in coronary heart-disease patients[J].Int J Cardiol,2017,244:17-23.DOI:10.1016/j.ijcard.2017.06.067.
[24]MUNK P S,BRELAND U M,AUKRUST P,et al.High intensity interval training reduces systemic inflammation in post-PCI patients[J].Eur J Cardiovasc Prev Rehabil,2011,18(6):850-857.DOI:10.1177/1741826710397600.
[25]HANNAN A L,HING W,SIMAS V,et al.High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation:a systematic review and meta-analysis[J].Open Access J Sports Med,2018,9:1-17.DOI:10.2147/OAJSM.S150596.
[26]TSCHENTSCHER M,EICHINGER J,EGGER A,et al.Highintensity interval training is not superior to other forms of endurance training during cardiac rehabilitation[J].Eur J Prev Cardiol,2016,23(1):14-20.DOI:10.1177/2047487314560100.
[27]GOMESNETO M,DUR?ES A R,REIS H F C D,et al.Highintensity interval training versus moderate-intensity continuous training on exercise capacity and quality of life in patients with coronary artery disease:A systematic review and meta-analysis[J].Eur J Prev Cardiol,2017,24(16):1696-1707.DOI:10.1177/2047487317728370.
[28]SOROFF H S,HUI J,GIRON F.Current status of external counterpulsation[J].Crit Care Clin,1986,2(2):277-295.
[29]Task Force Members,MONTALESCOT G,SECHTEM U,et al.2013 ESC guidelines on the management of stable coronary artery disease:the Task Force on the management of stable coronary artery disease of the European Society of Cardiology[J].Eur Heart J,2013,34(38):2949-3003.DOI:10.1093/eurheartj/eht296.
[30]国际体外反搏学会,中国康复医学会心血管病专业委员会,中国老年学学会心脑血管病专业委员会.心血管疾病康复处方--增强型体外反搏应用国际专家共识[J].中华内科杂志,2014,53(7):587-590.DOI:10.3760/cma.j.issn.0578-1426.2014.07.024.
[31]SARDARI A,HOSSEINI S K,BOZORGI A,et al.Effects of enhanced external counterpulsation on heart rate recovery in patients with coronary artery disease[J].J Tehran Heart Cent,2018,13(1):13-17.
[32]RAZA A,STEINBERG K,TARTAGLIA J,et al.Enhanced External Counterpulsation Therapy:Past,Present,and Future[J].Cardiol Rev,2017,25(2):59-67.DOI:10.1097/CRD.0000000000000122.
[33]肖永莉,李兴国,刘品,等.体外反搏治疗冠状动脉粥样硬化性心脏病的疗效观察[J].中国循证心血管医学杂志,2016,8(3):311-313.DOI:10.3969/j.issn.1674-4055.2016.03.15.
[34]孙刚,吴宇红,张学芳,等.增强型体外反搏对不稳定型心绞痛患者经皮冠状动脉介入治疗后血流的短期效应与安全性[J].岭南心血管病杂志,2018,24(1):9-13.DOI:10.3969/j.issn.1007-9688.2018.01.03.
[35]宋孟仙,刘华,王雯霞,等.体外心脏震波治疗对缺血性心力衰竭患者的疗效及其机制研究[J].临床心血管病杂志,2016,32(9):938-942.
[36]KAISER R A,LIANG Q,BUENO O,et al.Genetic Inhibition or Activation of JNK1/2 Protects the Myocardium from IschemiaReperfusion-induced Cell Death in Vivo[J].J Biol Chem,2005,280(38):32602-32608.DOI:10.1074/jbc.M500684200.
[37]YANG W,YAN H,GAN L,et al.Cardiac shock wave therapy promotes arteriogenesis of coronary micrangium,and ILK is involved in the biomechanical effects by proteomic analysis[J].Sci Rep,2018,8(1):1814.DOI:10.1038/s41598-018-19393-z.
[38]YU W,SHEN T,LIU B,et al.Cardiac shock wave therapy attenuates H9c2 myoblast apoptosis by activating the AKT signal pathway[J].Cell Physiol Biochem,2014,33(5):1293-1303.DOI:10.1159/000358697.
[39]ZUOZIENE G,LEIBOWITZ D,CELUTKIENE J,et al.Multimodality imaging of myocardial revascularization using cardiac shock wave therapy[J].Int J Cardiol,2015,187:229-230.DOI:10.1016/j.ijcard.2015.03.306.
[40]NIRALA S,WANG Y,PENG Y Z,et al.Cardiac shock wave therapy shows better outcomes in the coronary artery disease patients in a long term[J].Eur Rev Med Pharmacol Sci,2016,20(2):330-338.
[41]LIU B,ZHANG Y,JIA N,et al.Study of the Safety of Extracorporeal Cardiac Shock Wave Therapy:Observation of the Ultrastructures in Myocardial Cells by Transmission Electron Microscopy[J].J Cardiovasc Pharmacol Ther,2017,23(1):79-88.DOI:10.1177/1074248417725877.
[42]刘伟静,沈建颖,朱梦云,等.体外心脏震波治疗顽固性心绞痛的有效性和安全性[J].上海医学,2017,40(4):206-209.
[43]AENGEVAEREN V L,MOSTERD A,BRABER T L,et al.Relationship Between Lifelong Exercise Volume and Coronary Atherosclerosis in Athletes[J].Circulation,2017,136(2):138-148.DOI:10.1161/CIRCULATIONAHA.117.027834.