经皮冠状动脉介入术后患者Ⅰ期心脏康复运动时长的影响因素

doi:10.3969/j.issn.1006-9771.2025.12.005

摘要/Abstract

摘要：

目的调查经皮冠状动脉介入术(PCI)后患者Ⅰ期心脏康复运动时长现状，并分析其影响因素。
方法回顾分析2022年5月至2024年5月行PCI且术后参与Ⅰ期心脏康复患者120例，采用自制调查表收集临床资料，记录心脏康复运动时长。
结果心脏康复运动时长为每天(19.45±6.32) min，疲劳(62.55±4.37)分，家庭支持(84.87±10.65)分，运动恐惧(41.98±5.24)分；不同年龄、体质量、心功能分级、术后是否并发心绞痛、术后制定营养干预的患者，康复运动时长有显著性差异(P < 0.05)。Pearson相关性分析显示，康复运动时长与疲劳(r = -0.247, P < 0.05)、运动恐惧(r = -0.235, P < 0.05)、家庭支持(r = 0.206, P < 0.05)相关。多元线性回归分析显示，术后并发心绞痛(B = -3.210, 95%CI -5.564~-0.855)、术后制定营养干预(B = -3.738, 95%CI -6.790~-0.686)、疲劳(B = -0.182, 95%CI -0.349~-0.014)、家庭支持(B = 0.086, 95%CI 0.003~0.169)、运动恐惧(B = -0.139, 95%CI -0.248~-0.030)均是康复运动时长的独立影响因素(P < 0.05)。结构方程显示，5个独立影响因素对康复运动时长均有直接效应，术后并发心绞痛和术后制定营养干预还有间接效应。
结论 PCI术后患者Ⅰ期心脏康复运动时长有待提高，患者术后并发心绞痛、未制定营养干预、疲劳、运动恐惧以及家庭支持不足均会影响康复运动时长，应采取针对性干预，促进患者术后恢复。

关键词: 经皮冠状动脉介入术, 心脏疾病, 心脏康复, 影响因素

Abstract:

Objective To investigate the current status of exercise duration of phase I cardiac rehabilitation for patients after percutaneous coronary intervention (PCI), and analyze its related factors.
Methods A total of 120 patients who underwent PCI and participated in phase I cardiac rehabilitation from May, 2022 to May, 2024 were reviewed. Their clinical data were collected using a self-designed questionnaire, and the exercises duration of cardiac rehabilitation was recorded.
Results The average daily exercise duration of cardiac rehabilitation was (19.45±6.32) minutes. The scores of fatigue, family support and exercise fear were (62.55±4.37), (84.87±10.65) and (41.98±5.24), respectively. There were significant differences in the exercise duration of rehabilitation among patients with different ages, body mass, cardiac function grades, presence or absence of postoperative angina pectoris, and presence or absence of postoperative nutritional intervention (P < 0.05). Pearson's correlation analysis showed that the exercise duration of rehabilitation correlated with the scores of fatigue (r = -0.247, P < 0.05), exercise fear (r = -0.235, P < 0.05) and family support (r = 0.206, P < 0.05). Multiple linear regression analysis revealed that postoperative angina pectoris (B = -3.210, 95%CI -5.564 to -0.855), postoperative nutritional intervention (B = -3.738, 95%CI -6.790 to -0.686), fatigue (B = -0.182, 95%CI -0.349 to -0.014), family support (B = 0.086, 95%CI 0.003 to 0.169) and exercise fear (B = -0.139, 95%CI -0.248 to -0.030) were independent factors relating to the duration of rehabilitation exercise (P < 0.05). Structural equation modeling showed that there were direct effects of all the five independent factors on the exercise duration of rehabilitation, while indirect effects were found in postoperative angina pectoris and postoperative nutritional intervention.
Conclusion It is needed to improve the exercise duration of phase I cardiac rehabilitation for patients after PCI. Postoperative angina pectoris, lack of nutritional intervention, fatigue, exercise fear and insufficient family support can all influence the exercise duration of rehabilitation, which should be appropriately administer to promote the postoperative outcome.

Key words: percutaneous coronary intervention, heart disease, cardiac rehabilitation, related factor

中图分类号:

R541.4

薛蕾. 经皮冠状动脉介入术后患者Ⅰ期心脏康复运动时长的影响因素[J]. 《中国康复理论与实践》, 2025, 31(12): 1414-1420.

XUE Lei. Factors relating with exercise duration of phase I cardiac rehabilitation for patients after percutaneous coronary intervention[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(12): 1414-1420.

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项目	条目数	维度均分	条目均分
疲劳总分	20	62.55±4.37	3.21±0.28
体力疲劳	10	30.74±2.18	3.06±0.32
脑力疲劳	4	12.32±1.96	2.98±1.11
动力下降	3	9.63±1.21	3.17±0.33
活动减少	3	9.45±1.88	3.15±0.46
家庭支持总分	30	84.87±10.65	2.83±0.36
亲密度	16	45.31±5.28	2.81±0.47
适应度	14	39.65±6.47	2.83±0.46
运动恐惧总分	17	41.98±5.24	2.47±0.31
危险感知	4	9.91±1.23	2.51±0.33
运动恐惧	4	9.87±1.30	2.51±0.29
运动回避	5	12.56±1.77	2.67±0.58
功能紊乱	4	10.23±1.42	2.54±0.36

特征		n	康复运动时长/(min·d^-1)	t/F值	P值
年龄	< 60岁	57	19.68±6.24	2.178	0.031
年龄	≥ 60岁	63	17.41±5.17	2.178	0.031
性别	男	66	19.24±6.08	0.063	0.950
性别	女	54	19.31±5.99	0.063	0.950
住院时间	≤ 1周	78	19.21±5.86	1.795	0.075
住院时间	> 1周	42	17.42±3.69	1.795	0.075
病程	< 5年	84	19.34±6.27	0.064	0.949
病程	≥ 5年	36	19.26±6.35	0.064	0.949
体质量	偏瘦	15	15.54±4.27	3.962	0.022
	正常	87	19.51±6.86
	超重/肥胖	18	16.11±5.24
NYHA心功能分级	≤ Ⅱ级	98	19.51±6.68	2.773	0.007
NYHA心功能分级	> Ⅱ级	22	15.36±4.47	2.773	0.007
受教育程度	高中及以下	15	19.42±6.25	0.012	0.987
	专科	47	19.39±6.31
	本科及以上	58	19.40±6.27
家庭人均月收入	< 3000元	14	19.44±6.33	0.012	0.988
	3000~8000元	64	19.21±6.38
	> 8000元	42	19.37±6.42
职业	在职	37	19.35±6.38	0.001	0.999
	无业/自由职业	31	19.41±6.27
	退休	52	19.39±6.30
术后并发心绞痛	有	24	16.32±4.65	2.131	0.035
术后并发心绞痛	无	96	19.27±6.36	2.131	0.035
术后制定营养干预	有	68	19.59±6.21	1.991	0.049
术后制定营养干预	无	52	17.54±4.65	1.991	0.049

因素	n	r	SE	P	95%置信区间
因素	n	r	SE	P	下限	上限
疲劳	120	-0.247	0.075	0.007	-0.393	-0.094
家庭支持	120	0.206	0.087	0.024	0.040	0.379
运动恐惧	120	-0.235	0.086	0.010	-0.411	-0.065

变量	赋值
年龄	< 60岁 = 0，≥ 60岁 = 1
体质量	正常 = 0，偏瘦/超重/肥胖 = 1
NYHA心功能分级	≤ Ⅱ级 = 0，> Ⅱ级 = 1
术后并发心绞痛	无 = 0，有 = 1
术后制定营养干预	有 = 0，无 = 1
疲劳	原值
家庭支持	原值
运动恐惧	原值

变量	未标准化系数		β值	t值	P值	95%置信区间		共线性检验
变量	B	SE	β值	t值	P值	下限	上限	容差	VIF
常量	16.581	3.696	-	2.541	0.012	4.975	26.188	-	-
年龄	-1.107	0.100	-0.111	-1.071	0.286	-0.306	0.091	0.732	1.710
体质量	-1.090	1.627	-0.095	-0.670	0.504	-4.313	2.132	0.391	2.556
NYHA心功能分级	0.081	1.549	0.003	0.031	0.975	-3.052	3.116	0.662	1.510
术后并发心绞痛	-3.210	1.189	-0.281	-2.700	0.008	-5.564	-0.855	0.699	1.430
术后制定营养干预	-3.738	1.541	-0.325	-2.425	0.017	-6.790	-0.686	0.440	2.275
疲劳	-0.182	0.085	-0.223	-2.152	0.034	-0.349	-0.014	0.724	1.382
家庭支持	0.086	0.042	0.205	2.041	0.043	0.003	0.169	0.792	1.263
运动恐惧	-0.139	0.055	-0.237	-2.524	0.013	-0.248	-0.030	0.865	1.156