急性心肌梗死患者急诊介入治疗后早期运动试验的可行性研究

The feasibility of early exercise test for the patients of acute myocardial infarction after emergency percutaneous coronary intervention

[目的]评价急性心肌梗死(AMI)患者行急诊介入治疗(PCI)后早期运动试验的安全性和可行性, 为制定个体化的治疗方案提供参考标准。[方法]观察组为AMI患者,急诊PCI术后(12±5)d进行平板运动试验,对照组为稳定型心绞痛患者行PCI治疗后(189±21)d常规术后随访运动试验。观察两组运动时间、心率变化、代谢当量、心电图变化、缺血症状及严重并发症等指标,并进行统计学分析。[结果]与对照组相比, 心梗组运动试验中最高心率较低[(131±19)vs(159±24)次／min,P<0．05)],运动时间相对较短[(6．5± 4．3)vs(8．5±3．4)min,P<0．05)],METS值较低[(5．4±1．3)vs(7．1±1．9),P<0．01)],出现症状者也较多(5 vs 1,P<0．05)。两组最大收缩压、ST段最大变化、心电图变化导联数、PCI血管对应导联出现心电图变化例数无明显差异。两组均未出现急性心力衰竭、新发SI段抬高、室颤、休克等严重并发症。[结论]AMI患者行急诊PCI治疗后,早期进行运动试验是安全和可行的,适合临床推广。

[Objective] To study the feasibility and security of early exercise test for the patients of acute myocardial infarct ion（ A MI） after emergency percutaneous coronary intervention（ PCI）, for providing t he reference criterion for individual treatment. [Methods] Exercise test were undertaken in AMI patients after emergency PCI at （12 ± 5） days. At the same time,some angina patients after PCI for about 6 months at （ 189 ± 21）day were undertaken exercise test too. The exercise time,changes of heart rate, METS, variety of cardiogram and the numbers of patients with symptom were observed and compared. [Results] Compared with angina patients, the fastest heart rate were low[ （131 ± 19） vs （159 ± 24） beats/ min, P 〈 0.05）] ,the exercise time were short[（6.5 ± 4.3） vs （8.5 ± 3.4） min, P 〈 0.05） ] METS were low[（5.4 ± 1.3） vs （7.1 ± 1.9）, P 〈 0.01 ] and the number of patients with symptom was more（5 vs 1, P 〈 0.05） in AM I patients. However, there was no difference on the changes of blood pressure, the rarity of ST segment, the leads of change cardiogram PCI coronary corresponding,and severe side-effect in the two groups. [ Conclusion] Early exercise test for AM I patients after PCI is safe, feasible and can be popularize.