摘要
目的:探讨三维斑点追踪成像(3D-STI)技术评估急性心肌梗死患者经皮冠状动脉介入(PCI)术后行早期心脏康复运动对心功能的影响。方法:选取医院收治的100例单支病变急性ST段抬高型心肌梗死患者,所有患者均接受PCI治疗,术后按双盲法随机分为对照组和观察组,每组50例。对照组术后采用一般护理模式及常规运动教育训练,观察组在对照组护理模式的基础上,术后尽早进行为期3个月的心脏康复运动训练。PCI术后所有患者均接受3D-STI检查,获得左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左室整体纵向应变(GLS)、整体面积应变(GAS)、整体径向应变(GRS)及周向应变(GCS)等参数。在心脏康复运动训练前后,所有患者均接受心肺运动测试及明尼苏达心衰生活质量问卷表(MLWHFQ)进行调查,获得最大运动功率、最大运动时间、峰值耗氧量(Peak VO_(2))、无氧阈氧耗量(VO_(2) AT)及生活质量分数。结果:训练3个月后观察组GLS、GRS、GAS及LVEF高于对照组,其差异有统计学意义(t=2.511,t=4.116,t=3.355,t=-5.306;P<0.05),GCS、LAD及LVEDD低于对照组,其差异有统计学意义(t=2.569,t=4.553,t=2.523;P<0.05)。训练3个月后观察组最大运动功率、最大运动时间、Peak VO_(2)及VO_(2) AT高于对照组,其差异有统计学意义(t=-7.756,t=-4.270,t=-3.113,t=-3.742;P<0.05)。观察组训练前后心肺运动测试最大运动功率、最大运动时间、Peak VO_(2)及VO_(2) AT比较,差异有统计学意义(t=2.017,t=3.325,t=9.117,t=2.894;P<0.05),训练3个月后观察组MLWHFQ评分低于对照组,组间差异有统计学意义(t=8.001,P<0.05)。结论:3D-STI技术可敏感评估早期心脏康复运动对心功能的影响,为心肌梗死患者介入术后尽早开始心脏康复提供参考信息,完善心脏康复体系,提高心脏康复覆盖率及患者参与度。
Objective:To investigate the effect of early cardiac rehabilitation exercise after percutaneous coronary intervention(PCI)for patients with acute myocardial infarction on cardiac function by the evaluation of threedimensional speckle tracking imaging(3D-STI).Methods:100 patients with myocardial infarction of single-vessel acute ST-segment elevation admitted to hospital were selected,and all of them received PCI,and they were randomly divided into control group and observation group according to double-blind method after operation,with 50 cases in each group.The control group received general nursing mode and routine exercise education after operation,and the observation group received the training of cardiac rehabilitation exercise for 3 months as early as possible on the basis of the nursing mode of the control group.After PCI,all of them received 3D-STI examination for obtaining left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),global longitudinal strain(GLS)of left ventricle,overall area strain(GAS),global radial strain(GRS)and global circumferential strain(GCS)and other parameters.All patients received the tests of cardiopulmonary exercise and MLWHFQ questionnaires before and after the training of cardiac rehabilitation exercise for obtaining maximum exercise power,maximum exercise time,peak oxygen consumption(Peak VO_(2)),anaerobic threshold oxygen consumption(VO_(2) AT)and the scores of quality of life.Results:After 3 months of training,the GLS,GRS,GAS and LVEF of the observation group were significantly higher than those of the control group,and the differences were statistically significant(t=2.511,t=4.116,t=3.355,t=-5.306,P<0.05),and the GCS,LAD and LVEDD of the observation group were significantly lower than those of the control group(t=2.569,t=4.553,t=2.523,P<0.05),respectively.After 3 months of training,the maximum exercise power,maximum exercise time,Peak VO_(2) and VO_(2) AT of the observation group were significantly higher than those
作者
徐乐
温德惠
刘俊峰
赵坤
李卫天
张敏秀
陈伟广
马崇
XU Le;WEN De-hui;LIU Jun-feng(Department of Ultrasound Medicine,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;不详)
出处
《中国医学装备》
2023年第3期80-84,共5页
China Medical Equipment
基金
河北省2021年度医学科学研究课题计划(20211139)“三维斑点追踪技术评估心梗PCI术后早期心脏康复效果的研究”。
关键词
三维斑点追踪(3D-STI)技术
心脏康复运动
急性心肌梗死
冠状动脉
介入
3-dimensional Speckle Tracking Imaging(3D-STI)
Cardiac rehabilitation exercise
Acute myocardial infarction
Coronary artery
Intervention
