无合并症急性心肌梗死患者早期康复治疗的一年随访

One year follow-up of the effect of early rehabilitation programme on patients with uncomplicated acute myocardial infarction

目的 对无合并症急性心肌梗死 (AMI)患者早期康复治疗 1年后随访期的病情作出评估。方法 前瞻性对 2 0 3例患者随机平行分为早期康复治疗组 (组 1,n =10 1例 )及对照组 (组 2 ,n =10 2例 )。二组主要基线资料具可比性。组 1采用早期康复治疗方案 ;组 2采用传统康复方案。患者出院后随访 1年 ,主要研究终点为死亡和再梗死 ,次要研究终点 :临床心功能分级、心绞痛分级、生活自理能力和精神状态。结果 失随访 14例 (组 1和组 2分别为 6例和 8例 ) ,随访率为 93.1%。随访期中两组在死亡、心肌再梗死、接受介入治疗、心功能分级、心绞痛分级、生活自理能力和精神状态的构成在统计学上差异无显著性 (P >0 .0 5 )。结论 无合并症AMI早期康复治疗并不增加远期死亡、心肌再梗死、心绞痛的发生率及接受介入治疗的例数 。

Objective To investigate the effects of early rehabilitation programme on patients with uncomplicated acute myocardial infarction(AMI) during one year follow up. Methods Two hundred and three consecutive patients with uncomplicated AMI admitted to CCU from June 1995 to September 1997 were prospectively ramdomised into early rehabilitation group (Group 1, n =101) and control group (Group 2, n =102). Patients in the two groups were well matched in terms of major baseline parameters. Patients in group 1 received early rehabilitation programme . Patients in group 2 received traditional rehabilitation programme. All patients were followed for one year. The primary endpoints were death and reinfarction.The secondary endpoints included cardiac function , angina ,the self care ability and the psychosis . Results Forteen patients were lost within follow up period , the rate of follow up was 93.1%. No significant differences were found between the two groups in terms of mortality , reinfarction, intervention ,cardiac function, angina, self care ability and psychosis. Conclusion Early rehabilitation programme does not increase the incidence of death , reinfarction , intervention and angina, and is not harmful to cardiac function and quality of life in patients with uncomplicated acute myocardial infarction.