摘要
目的探讨心脏运动康复对急性心肌梗死经皮冠状动脉介入治疗(PCI)术后的患者运动耐力的影响。方法前瞻性选取2021年1月至2021年12月三亚市中医院急性心肌梗死PCI术后100例患者分组,按照随机数字表法分为2组,分别为常规组(n=50)和康复组(n=50)。常规组接受常规治疗,康复组在常规组基础上予以心脏运动康复。术后随访观察6个月,评估两组患者的心功能、运动耐力;采用双重差分(DID)模型对比常规组和康复组PCI前后不同时间点(术前、术后1周、1个月、3个月、6个月)最大摄氧量(VO_(2)max)、无氧阈(AT);采用Kaplan-Meier曲线对比两组患者随访期间主要心血管不良事件发生率。结果康复组患者术后1周、1个月、3个月、6个月的左室收缩期内径(LVESD)、舒张末期内径(LVEDD)水平明显低于常规组,E/A、左室射血分数(LVEF)水平明显高于常规组,差异均有统计学意义(P<0.05)。康复组术后1周、1个月、3个月、6个月的VO_(2)max、AT水平明显高于常规组,差异均有统计学意义(P<0.05)。DID回归模型显示,术前,两组患者VO_(2)max差分效应量为0.080,AT差分效应量为0.095,两组VO_(2)max对比差异无统计学意义(P>0.05),术后各时间点,康复组的效应值明显高于常规组效应值,差异有统计学意义(P<0.05)。Kaplan-Meier曲线显示,随访期间康复组主要心血管不良事件发生率显著低于常规组(Log-rank χ^(2)=4.186,P=0.041)。结论心脏运动康复能提高急性心肌梗死PCI术后患者运动耐力,改善心功能,降低术后主要心血管不良事件发生率。
Objective To investigate the effect of cardiac exercise rehabilitation on exercise tolerance in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 100 patients with acute myocardial infarction after PCI in Sanya Hospital of Traditional Chinese Medicine from January 2021 to December 2021 were prospectively selected and divided into two groups according to random number table method,which were conventional group(n=50)and rehabilitation group(n=50).The routine group received routine treatment;the rehabilitation group received cardiac exercise rehabilitation on the basis of the routine group;followed up for 6 months,the cardiac function and exercise tolerance of the two groups were evaluated,and the DID model was used to compare the two groups at different time points before and after PCI(before and after surgery 1 week,1 month,3 months,6 months)maximum oxygen uptake(VO _(2)max),anaerobic domain(AT);Kaplan-Meier curve was used to compare the incidence of major cardiovascular adverse events during follow-up between the two groups.Results The levels of left ventricular systolic diameter(LVESD)and end-diastolic diameter(LVEDD)in the rehabilitation group were lower than those in the conventional group,while the levels of E/A and left ventricular ejection fraction(LVEF)were higher in the rehabilitation group than those in the conventional group,the differences were statistically significant(P<0.05).The levels of VO_(2)max and AT at each time point in the rehabilitation group were higher than those in the conventional group,the differences were statistically significant(P<0.05).The DID regression model showed that before surgery,the difference effect size of VO_(2)max between the two groups was 0.080,and the difference effect size of AT was 0.095,and there was no significant difference in VO_(2)max between the two groups(P>0.05).At each time point after surgery,the effect value of the rehabilitation group was significantly higher than that of the conventional group,the difference was statistically significant(P<0.05).The Kaplan-Meier curve showed that the incidence of major cardiovascular adverse events in the rehabilitation group was significantly lower than that in the routine group during follow-up(Log-rank χ^(2)=4.186,P=0.041).Conclusion Cardiac exercise rehabilitation can improve exercise endurance,improve cardiac function and reduce the incidence of major cardiovascular adverse events in patients with acute myocardial infarction after PCI.
作者
冯旭霞
崔小红
何喜民
王文静
吴文虎
尹培永
赵营营
FENG Xu-xia;CUI Xiao-hong;HE Xi-min(Department of Internal Medicine,Sanya Hospital of Traditional Chinese Medicine,Sanya Hainan 572000,China)
出处
《临床和实验医学杂志》
2023年第9期914-918,共5页
Journal of Clinical and Experimental Medicine
基金
海南省卫生健康行业科研项目(编号:21A200364)。
关键词
急性心肌梗死
经皮冠状动脉介入治疗
心脏运动康复
运动耐力
Acute myocardial infarction
Percutaneous coronary intervention
Cardiac exercise rehabilitation
Exercise endurance
