心脏康复治疗对AMI患者PCI术后预后的影响

Influence of cardiac rehabilitation on the prognosis of AMI patients after PCI

目的:研究心脏康复治疗对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后预后的影响.方法:2016年1~12月于我院行PCI术的AMI患者100例被随机均分为常规组和康复训练组(在常规组基础上接受康复训练),两组均治疗6个月.观察比较两组治疗前后血脂及空腹血糖(FPG)水平、LVEF、左室舒张末期内径(LVEDd)、血浆N基末端脑钠肽前体(NT-proBNP)水平、Borg劳累评估量表评分、焦虑自评量表(SAS)及抑郁自评量表(SDS)评分.结果:与常规组比较,康复训练组治疗后TG[(3.11±0.29)mmol/L比(2.43±0.81)mmol/L]、TC[(4.60±1.53)mmol/L比(4.04±1.21)mmol/L]、FPG[(5.48±0.83)mmol/L比(4.88±0.95)mmol/L]水平、LVEDd[(49.04±3.41)mm比(44.90±3.29)mm]、血浆NT-proBNP水平[(118.50±42.83)mmol/L比(86.16±33.84)mmol/L]、Borg劳累评估量表评分[(13.92±1.64)分比(12.74±1.85)分]、SAS评分[(46.94±5.13)分比(39.68±2.77)分]、SDS评分[(54.04±4.14)分比(45.42±3.41)分]降低更显著,LVEF[(44.90±6.21)%比(54.68±3.04)%]升高更显著(P<0.05或<0.01).结论:心脏康复治疗可显著改善AMI患者PCI术后的心功能、心理状态,调节血脂、血糖水平,提高运动耐力.

Objective:To study influence of cardiac rehabilitation(CR) on the prognosis of patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI). Methods:A total of 100 AMI patients undergoing PCI treated in our hospital from Jan 2016 to Dec 2016 were randomly and equally divided into routine group and rehabilitation training group(received rehabilitation training based on routine group). Both groups were treated for six months.Blood lipid and fasting plasma glucose(FPG), LVEF, left ventricular end-diastolic dimension(LVEDd), plasma level of N-terminal pro-brain natriuretic peptide(NT-proBNP), scores of Borg fatigue assessment scale, self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were observed and compared between two groups before and after treatment. Results:Compared with routine group, after treatment, there were significant reduction in levels of TG [(3.11±0.29)mmol/L vs.(2.43±0.81) mmol/L], TC [(4.60±1.53)mmol/L vs.(4.04±1.21) mmol/L] and FPG [(5.48±0.83)mmol/L vs.(4.88±0.95) mmol/L], LVEDd [(49.04±3.41)mm vs.(44.90±3.29) mm],plasma NT-proBNP level [(118.50±42.83)mmol/L vs.(86.16±33.84) mmol/L], scores of Borg fatigue assessment scale [(13.92±1.64)scores vs.(12.74±1.85)scores], SAS [(46.94±5.13)scores vs.(39.68±2.77)scores] and SDS[(54.04±4.14)scores vs.(45.42±3.41)scores] and significant rise in LVEF [(44.90±6.21)% vs.(54.68±3.04)%] in rehabilitation training group(P<0.05 or <0.01). Conclusion:CR can significantly improve cardiac function and psychological state, regulate levels of blood lipids and blood glucose and improve exercise tolerance in AMI patients after PCI.