个体化有氧运动治疗对直接PCI后心肺功能及心理状态的疗效

Curative effect of individualized aerobic exercise on cardiopulmonary function and mental state after primary percutaneous coronary intervention

目的探讨基于心肺评估的个体化有氧运动治疗方案对急性心肌梗死直接经皮冠状动脉介入治疗(PCI)后患者心肺功能及心理状态的疗效。方法收集深圳市盐田区人民医院急性ST段抬高心肌梗死行直接PCI后患者104例,其中常规治疗组56例,有氧运动组48例(常规治疗+有氧运动),并根据心肌梗死部位(前壁心肌梗死及非前壁心肌梗死)划分亚组。比较各组及各亚组间患者干预前、干预12 w后的左室射血分数(LVEF)、心脏指数(CI)、心肺评估相关指标包括无氧阈(AT)、最大摄氧量(VO2max)、氧峰值(O2pulse)、最大运动时间、6分钟步行实验以及焦虑自评量表(SAS)和抑郁自评量表(SDS)的情况。结果干预12 w后有氧运动组中前壁心肌梗死亚组的LVEF、CI、VO2max、O2pulse、最大运动时间、6 min步行实验结果均较常规治疗组中的前壁心肌梗死亚组高,P<0.05,具有统计学差异;而有氧运动组的前壁心肌梗死亚组及非前壁心肌梗死亚组SAS及SDS评分均较常规治疗组中对应亚组降低,P<0.05,具有统计学差异。结论基于心肺评估的个体化有氧运动治疗能缓解直接PCI后患者的负面情绪,同时能改善改善前壁心肌梗死直接PCI后患者的心肺功能。

Objective To discuss the curative effect of individualized aerobic exercise based on cardiopulmonary assessment on cardiopulmonary function and mental state in patients with acute myocardial infarction(AMI)after primary percutaneous coronary intervention(pPCI).Methods AMI patients(n=104)were chosen from People’s Hospital of Yantian District of Shenzhen City and divided into routine treatment group(n=56)and aerobic exercise group(routine treatment+aerobic exercise,n=48).The patients were further divided into subgroups according to locations of AMI(anterior AMI and non-anterior AMI).The indexes including left ventricular ejection fraction(LVEF)and cardiac index(CI),cardiopulmonary assessment indexes including anaerobic threshold(AT),maximal oxygen uptake(VO2max),oxygen peak(O2pulse),maximal movement time and 6-minute walk test(6MWT),and scores of self-rating anxiety scale(SAS)and self-rating depressive scale(SDS)were compared in all groups and subgroups before intervention and after intervention for 12 weeks.Results After intervention for 12 weeks,LVEF,CI,VO2max,O2pulse,maximal movement time and 6MWT all were higher in anterior AMI subgroup of aerobic exercise group than those in anterior AMI subgroup of routine treatment group(P<0.05).The scores of SAS and SDS were lower in anterior AMI subgroup and non-anterior AMI subgroup of aerobic exercise group than those in corresponding subgroups of routine treatment group(P<0.05).Conclusion The therapy of individualized aerobic exercise based on cardiopulmonary assessment can alleviate the negative emotions in AMI patients after pPCI,meanwhile improve cardiopulmonary function in patients with anterior AMI after pPCI.