Application effect of cardiopulmonary rehabilitation training combined with enhanced external counterpulsation in COPD patients complicated with non-high-risk stable angina pectoris

SUN Xiaojing; WANG Lizhong; ZHANG Zhenying; ZHANG Liu; XU Zhiping; YANG Cheng

doi:10.3969/j.issn.1674-3806.2024.12.12

Abstract：Objective To explore the effects of cardiopulmonary rehabilitation training combined with enhanced external counterpulsation(EECP)on cardiopulmonary reserve function,vascular endothelial function and athletic ability in chronic obstructive pulmonary disease(COPD)patients complicated with non-high-risk stable angina pectoris.Methods A total of 80 COPD patients complicated with non-high-risk stable angina pectoris who were admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from January 2020 to June 2022 were selected and randomly divided into control group(n=40)and observation group(n=40).The control group received basic treatment and cardiopulmonary rehabilitation training,while the observation group was supplemented with EECP intervention on the basis of the intervention in the control group.Both groups were treated for 5 weeks.The cardiopulmonary reserve function,vascular endothelial function,athletic ability,angina attack and quality of life were compared between the two groups.Results After intervention,forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC),maximal voluntary ventilation(MVV)and left ventricular ejection fraction(LVEF)in both groups were significantly elevated(P＜0.05),and these indicators in the observation group were higher than those in the control group(P＜0.05).After intervention,the levels of nitric oxide(NO)were significantly increased(P＜0.05),while the levels of endothelin-1(ET-1)and endothelial cell-specific molecule-1(ESM-1)were significantly decreased in both groups(P＜0.05),and the level of NO in the observation group was significantly higher than that in the control group(P＜0.05),and the levels of ET-1 and ESM-1 in the observation group were significantly lower than those in the control group(P＜0.05).After intervention,the total exercise time,the exercise tolerance and the spending time of ST segment depression by 0.1 mV were elevated,while the downward amplitude of ST segment was significantly decreased in both groups(P＜0.05),and the total exercise time,the exercise tolerance and the spending time of ST segment depression by 0.1 mV in the observation group were significantly higher than those in the control group(P＜0.05),and the downward amplitude of ST segment in the observation group was lower than that in the control group(P＜0.05).After intervention,the frequency and intensity of angina attacks were significantly decreased(P＜0.05),and the scores of Seattle Angina Questionnaire(SAQ)scale were significantly increased in both groups(P＜0.05),and the frequency and intensity of angina attacks in the observation group were significantly lower than those in the control group(P＜0.05),and the SAQ scores in the observation group were significantly higher than those in the control group(P＜0.05).After intervention,the scores of World Health Organization Quality of Life-BREF(WHOQOL-BREF)in physiological and psychological fields were significantly decreased in both groups(P＜0.05),and the scores of WHOQOL-BREF in the observation group were significantly higher than those in the control group(P＜0.05),but there was no significant change in the scores of environmental and social relations fields(P＞0.05).Conclusion Cardiopulmonary rehabilitation training combined with EECP can effectively improve cardiopulmonary reserve function,vascular endothelial function and athletic ability in COPD patients complicated with non-high-risk stable angina pectoris,and alleviate angina attack and improve quality of life.