抗阻运动对心肌梗死患者PCI术后心脏康复的影响

Effect of resistance exercise on cardiac rehabilitation after PCI in patients with myocardial infarction

目的:探讨抗阻运动对心肌梗死患者PCI术后心脏康复的影响。方法:将2015年2月~2017年2月我院收治的116例行经皮冠状动脉介入(PCI)术患者作为研究对象,将其随机等分为对照组和观察组,对照组术后接受常规治疗与延续护理,观察组在对照组基础上进行抗阻运动,比较两组出院当天与出院3月后肌钙蛋白T(cTnT)、脑钠肽(BNP)、内皮素1(ET-1)、一氧化氮(NO)水平、左室射血分数(LVEF)、左室收缩末内径(LVESD)及左室舒张末径(LVEDD)、生活质量(WHOQOL-BREF)评分、自理能力(Barthel指数)、6 min步行试验、心血管事件发生情况。结果:出院3个月后,观察组cTnT,BNP,ET-1水平明显低于对照组(P<0.05),NO水平、LVEF明显高于对照组(P<0.05);观察组LVESD,LVEDD明显小于对照组(P<0.05),WHOQOL-BREF量表中生理、心理、社会关系以及环境领域评分明显高于对照组(P<0.05);观察组Barthel指数与6 min步行距离均明显大于对照组(P<0.05),且心血管事件总发生率显著低于对照组(P<0.05)。结论:心肌梗死患者在PCI术后心脏康复过程中进行抗阻运动,可有效改善内皮功能,促进心功能恢复,增加患者运动耐力,提高生活质量与自理能力,显著降低心血管事件风险。

Objective：To explore the effect of resistance exercise on cardiac rehabilitation after percutaneous coronary intervention（PCI） in patients with myocardial infarction.Methods：To select 116 patients who underwent PCI from February 2015 to February 2017 in our hospital as the research object,and randomly divide them into control group and observation group.The control group received routine treatment and continuous nursing after operation,and the observation group received resistance exercise on the basis of the control group.To compare two groups of troponin T（cTnT）,brain natriuretic peptide（BNP）,endothelin 1（ET-1）,nitric oxide（NO） level,left ventricular ejection fraction（LVEF）,left ventricular end systolic diameter（LVESD） and left ventricular end diastolic diameter（LVEDD）,the quality of life（WHOQOL-BREF） score,self-care ability（Barthel index）,6 min walking test,and the incidence of cardiovascular events on the day of discharge and 3 months after discharge.Results：The levels of cTnT,BNP and ET-1 in the observation group were significantly lower than those in the control group 3 months after discharge（P〈0.05）,and the levels of NO and LVEF were significantly higher than those in the control group（P〈0.05）.LVESD and LVEDD in the observation group were significantly lower than those in the control group（P〈0.05）,and the scores of physiological,psychological,social relations and in environmental field in WHOQOL-BREF scale were significantly higher than those in the control group（P〈0.05）.The Barthel index and 6 min walking distance in the observation group were significantly higher than those in the control group（P〈0.05）,and the total incidence of cardiovascular events was significantly lower than those in the control group（P〈0.05）.Conclusion：Resistance exercise in patients with myocardial infarction in the process of cardiac rehabilitation after PCI,could effectively improve endothelial function,promote the recovery of cardiac function,increase the patient＇s exercise endurance,improve the quality of life and self-care ability,and significantly reduce the risk of cardiovascular events.