急诊经皮冠状动脉介入后血管再通心肌梗死患者家庭自主式心脏运动康复的疗效追踪分析

Efficacy of self-controlled cardiac exercise rehabilitation on postoperative AMI patients with revascularization treated by emergency PCI

目的探讨急诊经皮冠状动脉介入(PCI)后血管再通急性心肌梗死(AMI)患者家庭自主式心脏运动康复的疗效,为AMI患者的诊治提供参考。方法选取急诊PCI后血管再通的AMI患者80例,将患者随机分为观察组与对照组,每组40例,对照组患者住院及出院后日常活动,不给与任何心脏运动康复,观察组患者住院期间病情平稳后即可开展家庭自主式心脏运动康复,在出院后由患者自我开展运动和运动强度监测,观察患者干预前、干预6个月后心功能、肾功能变化及终点事件发生情况。结果两组左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、短轴缩短率(FS)干预前后组内比较差异无统计学意义(P>0.05),左心室射血分数(LVEF)对照组干预前后组内比较差异无统计学意义(P>0.05),心率对照组干预后较干预前明显改善(P<0.05),LVEF心率观察组干预后较干预前明显改善(P<0.05),且观察组干预后LVEF、心率较对照组改善明显(P<0.05);两组患者干预前、干预后肌酐和尿素组间及组内比较差异无统计学意义(P>0.05);对照组主要终点事件发生率为30.00%、次要终点事件为47.50%,观察组为15.00%、25.00%,次要终点事件发生率观察组低于对照组(P<0.05)。结论家庭自主式心脏运动康复能有效改善急诊PCI后血管再通AMI患者心室功能,有助于减少次要终点事件的发生,同时对肾功能无明显影响。

Objective To observe the effect of self-controlled cardiac exercise rehabilitation on postoperative AMI patients with revascularization treated by emergency PCI.Methods 80 AMI patients with revascularization treated by emergency PCI were enrolled and randomly divided into observation group(40 cases)and control group(40 cases).Patients in the observation group start to have self-controlled cardiac excise rehabilitation after they were stable in hospital and being discharged from hospital,while those in the control group did regular excise.The cardiac function and renal function before and 6 months after the intervention were monitored and compared.Results The differences in LVESD,LVEDD and FS were not significant before and after intervention in both groups(P>0.05).while the differences in heart rate in the control group and both LVEF and heart rate in the observation group were statistically significant before and after intervention(P<0.05).LVEF and heart rate of the observation group significantly improved after intervention compared with the control group(P<0.05).There were no significant differences in the serum levels of creatinine and urea between the two groups as well as before and after the intervention within the group(P>0.05).The incidence of primary and secondary endpoint events were 30.00%,47.50%in the control group and 15.00%,25.00%in the observation group,the difference in th incidence of secondary endpoint events was lower in the observation group than that in the control group(P<0.05).Conclusions Self-controlled cardiac exercise rehabilitation may greatly improve ventricular function of postoperative AMI patients with revascularization treated by emergency PCI,it is helpful to reduce the occurrence of secondary endpoint events with no obvious effect on renal function.