摘要
目的探究渐进式Ⅰ、Ⅱ期心脏康复对冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后运动耐量、心功能和预后的影响。方法选取达州市中西医结合医院2018年1月至2019年12月收治的120例冠心病PCI治疗后患者作为研究对象,随机分为对照组(n=60)和心脏康复组(n=60)。对照组给予常规药物对症支持治疗;康复组在对照组基础上实施渐近式Ⅰ、Ⅱ期心脏康复运动治疗。比较治疗前后两组患者6 min步行实验(6MWT)结果、心脏功能及预后相关指标变化。结果治疗前及出院时,两组患者左心室射血分数(left ventricular ejection fraction,LVEF)、左心室缩短率(left ventricular fractional shortening,LVFS)、左心室舒张末期内径(left ventricular internal diameter at end-diasto⁃le,LVIDd)、左心室收缩末期内径(left ventricular internal diameter at end-systolic,LVIDs)比较,差异无统计学意义(P>0.05);治疗3个月及6个月后,患者心功能好转,且与对照组患者比较,康复组患者LVEF(53.07%±3.14%vs.59.54%±5.61%)和LVFS(37.02%±0.29%vs.38.72%±4.31%)明显上升,LVIDd[(47.01±1.39)mm vs.(44.43±1.91)mm]和LVIDs[(30.14±3.11)mm vs.(28.85±4.64)mm)]显著下降,差异均具有统计学意义(P<0.05)。出院时、治疗3个月及6个月后,患者心肌指标N末端脑钠肽前体(NT-pro brain natriuretic peptide,NTproBNP)、心肌肌钙蛋白Ⅰ(cardiac troponin I,cTnI)及肌酸激酶(creatine kinase-MB,CK-MB)较治疗前均持续下降,且治疗6个月后康复组患者上述心肌指标明显低于对照组,差异有统计学意义(P<0.05)。康复组患者行心脏康复治疗后,出院时、治疗3个月及6个月后的6 min步行距离(6-minute walking test,6MWT)为(465±71.31)m和(496±63.11)m,均显著高于对照组,差异有统计学意义(P<0.05)。康复组患者预后心功能分级较对照组也有明显改善,且主要不良心血管事件发生情况减少,差异有统计学意�
Objectives To investigate the effects of progressive stageⅠandⅡcardiac rehabilitation on exercise toler⁃ance,cardiac function and prognosis in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 120 patients with coronary heart disease admitted to Dazhou Integrated Hospital of Tradi⁃tional Chinese and Western Medicine after PCI were selected as study subjects from January 2018 to December 2019,and randomly divided into control group(n=60)and cardiac rehabilitation group(n=60).Control group was given symptomatic treatment with conventional drugs.On the basis of control group,the patients in rehabilitation group were treated with the progressive stageⅠandⅡcardiac rehabilitation exercise therapy.The changes of 6-minute walking test(6MWT)results,cardiac function and prognostic myocardial indicators between the two groups were compared before and after treatment.Results There was no significant difference in left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular internal diameter at end-diastole(LVIDd)and left ventricular internal diameter at end-systolic(LVIDs)between the two groups before treatment and after discharge(P>0.05).After 3 months and 6 months of treatment,compared with those of control group,LVEF(53.07%±3.14%vs.59.54%±5.61%)and LVFS(37.02%±0.29%vs.38.72%±4.31%)significantly increased,LVIDd[(47.01±1.39)mm vs(.44.43±1.91)mm]and LVIDs[(30.14±3.11)mm vs.(28.85±4.64)mm)]significantly decreased.The differences between the two groups were statistically significant(P<0.05).At the time of discharge,3 months and 6 months after treatment,the myocardial indexes NT-pro brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI)and creatine kinase-MB(CK-MB)of patients continued to decrease compared with those before treatment,and the myocardial indexes in observation group were significantly lower than those in control group after 6 months of treatment(P<0.05).After cardiac reha⁃bilitation treatment
作者
刘红梅
冯胜红
任静
任焱
LIU Hong-mei;FENG Sheng-hong;REN Jing;REN Yan(Department of Cardiology,Dazhou Integrated Hospital of Traditional Chinese and Western Medicine,Dazhou,Sichuan 635000,China)
出处
《岭南心血管病杂志》
CAS
2021年第6期640-645,共6页
South China Journal of Cardiovascular Diseases
基金
达州市2018市级医学科研立项课题(项目编号:2018008)。
关键词
冠状动脉疾病
Ⅰ、Ⅱ期心脏康复
运动耐量
心功能
预后
coronary heart disease
stageⅠandⅡcardiac rehabilitation
exercise tolerance
cardiac function
prog⁃nosis
