不同强度心脏康复训练对老年冠心病患者 肌少症、跌倒风险及生活质量影响的 回顾性分析

Retrospective Analysis of the Effects of Different Intensities of Cardiac Rehabilitation Training on Sarcopenia, Fall Risk and Quality of Life in Elderly Patients with Coronary Heart Disease

摘要: 目的：探讨不同强度心脏康复训练对老年冠心病患者肌少症、跌倒风险及生活质量的影响，为优化老年冠心病患者的康复方案提供循证依据。方法：回顾性分析2022年1月至2024年12月新疆医科大学第六附属医院康复医学科收治的45例老年冠心病患者临床资料，根据康复训练强度分为低强度组(LIT组，n = 15)、中等强度组(MICT组，n = 15)及高强度间歇组(HIIT组，n = 15)。比较三组患者干预前后肌少症相关指标[握力、步速、四肢骨骼肌指数(SMI)]、跌倒风险评估结果[起立–行走计时测试(TUGT)、Tinetti平衡步态量表评分]及生活质量评分(SF-36量表)。结果：干预前，三组患者握力、步速、SMI、TUGT、Tinetti评分及SF-36各维度评分差异均无统计学意义(P > 0.05)。干预3个月后，三组患者握力、步速、SMI均较干预前显著提高，TUGT显著缩短，Tinetti评分及SF-36各维度评分显著升高(P < 0.05)；且HIIT组上述指标改善幅度显著优于MICT组和LIT组，MICT组显著优于LIT组(P < 0.05)。结论：不同强度心脏康复训练均可改善老年冠心病患者肌少症、降低跌倒风险并提高生活质量，其中高强度间歇训练的改善效果更显著，临床可根据患者心功能及耐受情况个体化选择康复强度。

Abstract: Objective: To investigate the effects of different intensities of cardiac rehabilitation training on sarcopenia, fall risk and quality of life in elderly patients with coronary heart disease, so as to provide evidence-based basis for optimizing rehabilitation programs for these patients. Methods: Clinical data of 45 elderly patients with coronary heart disease admitted to the Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Xinjiang Medical University from January 2022 to December 2024 were retrospectively analyzed. According to the intensity of rehabilitation training, the patients were divided into low-intensity training group (LIT group, n = 15), moderate-intensity continuous training group (MICT group, n = 15) and high-intensity interval training group (HIIT group, n = 15). Sarcopenia-related indicators [grip strength, walking speed, skeletal muscle index (SMI)], fall risk assessment results [timed up and go test (TUGT), Tinetti balance and gait scale score] and quality of life score (SF-36 scale) were compared among the three groups before and after intervention. Results: Before intervention, there were no statistically significant differences in grip strength, walking speed, SMI, TUGT, Tinetti score and all dimensions of SF-36 scores among the three groups (P > 0.05). After 3 months of intervention, grip strength, walking speed and SMI in the three groups were significantly increased compared with those before intervention, TUGT was significantly shortened, and Tinetti score and all dimensions of SF-36 scores were significantly elevated (P < 0.05). The improvement of the above indicators in the HIIT group was significantly better than that in the MICT group and LIT group, and the MICT group was significantly better than the LIT group (P < 0.05). Conclusion: Cardiac rehabilitation training of different intensities can improve sarcopenia, reduce fall risk and improve quality of life in elderly patients with coronary heart disease, among which high-intensity interval training has a more significant effect. The rehabilitation intensity can be individually selected clinically according to the patients’ cardiac function and tolerance.