术后即刻康复训练对急性心肌梗死经皮冠状动脉介入患者炎性因子、氧化应激因子的影响

The effect of immediate postoperative rehabilitation training on inflammatory factors and oxidative stress factors of PCI patients with acute myocardial infarction

目的研究术后即刻康复训练(Immediate postoperative rehabilitation training,IPRT)对急性心肌梗死(Acute myocardial infarction,AMI)经皮冠状动脉介入术(PCI)患者炎性因子及氧化应激因子的影响。方法纳入2015年10月至2018年9月于我院行急诊PCI的急性心肌梗死(AMI)患者126例,依据随机数字表法分为即刻组(n=63)与常规组(n=63),常规组术后行常规护理,即刻组术后行常规护理+IPRT。观察两组健康状况评分,血清基质金属蛋白酶-9(MMP-9)、E选择素(E-selectin)、可溶性血管黏附分子-1(sVCAM-1)、可溶性细胞间黏附分子-1(sICAM-1)等炎性因子水平,丙二醛(MDA)、超氧化物歧化酶(SOD)等氧化应激因子水平,康复训练后心脏不良事件;PCI后1天、康复训练后左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)与左室射血分数(LVEF)等心功能指标。结果康复训练后,即刻组各健康状况评分、LVEF、MDA高于常规组,LVEDVI、LVESVI、MMP-9、E-selectin、sVCAM-1、sICAM-1、SOD低于常规组(P<0.05);且即刻组心脏不良事件发生率(12.70%)低于常规组(31.75%),差异有统计学意义(P<0.05)。结论IPRT可有效改善患者心功能,清除炎性因子,纠正氧化应激,提高其生命质量,减少心脏不良事件。

Objective To investigate the effect of immediate postoperative rehabilitation training(IPRT)on inflammatory factors and oxidative stress factors of patients with acute myocardial infarction(AMI)undergone percutaneous coronary interventionjavascript(PCI).Methods A total of 126 patients with AMI who underwent emergency PCI in our hospital from October 2015 to September 2018 were included in this study.The patients were divided into immediate group and routine group using the random number table method,63 in each group.The routine nursing was performed in the routine group after PCI,and routine nursing and IPRT were performed in the immediate group after PCI.The health score,the levels of inflammatory factors such as serum matrix metalloproteinases-9(MMP-9),E-selectin,soluble vascular adhesion molecule-1(sVCAM-1)and soluble intercellular adhesion molecule-1(sICAM-1),the levels of oxidative stress factors such as malondialdehyde(MDA)and superoxide dismutase(SOD)before PCI and after IPRT,and the adverse cardiac events after IPRT were observed.The heart function parameters such as the left ventricle end-diastolic volume index(LVEDVI),the left ventricular end-systolic volume index(LVESVI)and the left ventricular ejection fraction(LVEF)on the 1st day after PCI and after IPRT were also observed.Results After IPRT,the health score and the levels of LVEF and MDA in the immediate group were higher than those in the routine group,while the levels of LVEDVI,LVESVI,MMP-9,E-selectin,sVCAM-1,sICAM-1 and SOD were lower than those in the routine group(P<0.05).The incidence rate of adverse cardiac events in the immediate group(12.70%)was lower than that in the routine group(31.75%)(P<0.05).Conclusion IPRT can effectively improve the patients'cardiac function,eliminate the inflammatory factors,correct the oxidative stress,improve the quality of life and reduce the adverse cardiac events.