Ⅰ期心脏康复对急性ST段抬高型心肌梗死患者急诊PCI术后疗效及预后的影响

Effect of phaseⅠcardiac rehabilitation on the efficacy and prognosis of patients with acute STEMI after emergency PCI

目的探讨Ⅰ期心脏康复对急性ST段抬高型心肌梗死(STEMI)患者急诊PCI术后疗效及预后的影响。方法选取景德镇市第一人民医院心内科2019年6月至2021年6月收治并成功实施急诊PCI术的STEMI患者80例,随机分为对照组和试验组,每组各40例。对照组术后给予常规治疗,试验组在对照组的基础上加用Ⅰ期心脏康复治疗,比较两组术后1周及术后4周心功能[血浆肌钙蛋白(cTnI)、血浆脑钠肽水平(BNP)及左室射血分数(LVEF)]、生活质量、心血管事件(MACE)发生率及住院时间。结果两组术后1周心功能相关指标差异无统计学意义(P>0.05);术后4周心功能相关指标比较,差异有统计学意义(P<0.001)。试验组术后4周生活质量评分高于对照组,差异有统计学意义(P<0.001)。试验组术后4周MACE发生率低于对照组,差异有统计学意义(P<0.001),且试验组平均住院时间短于对照组,差异有统计学意义(P<0.05)。结论STEMI患者急诊PCI术后给予Ⅰ期心脏康复治疗能够提高心脏功能、生活质量,缩短住院时间,降低MACE发生。

Objective To investigate the effect of phase I cardiac rehabilitation on the efficacy and prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods A total of 80 patients with STEMI who were admitted to Jingdezhen NO.1 People′s Hospital and successfully underwent emergency PCI from June 2019 to June 2021 were selected as the study subjects.They were randomly divided into the control group and the experimental group,with 40 patients in each group.The control group was given conventional treatment after operation,while the experimental group was given phase I cardiac rehabilitation on the basis of the same treatment as the control group.The cardiac function(cardiac Troponin I,cTnI),brain natriuretic peptide(BNP levels),left ventricular ejection fraction(LVEF),quality of life,incidence of major adverse cardiovascular events(MACE)and length of stay were compared between the two groups.Results There were no statistically significant differences between the two groups in the cardiac function-related indicators at 1 week after operation(P>0.05).However,there were statistically significant differences between the two groups in the cardiac function-related indicators at 4 weeks after operation(P<0.001).The quality of life scores were higher in the experimental group than those in the control group at 4 weeks after operation,with statistically significant difference(P<0.001).The incidence of MACE was lower in the experimental group than that in the control group at 4 weeks after operation,with statistically significant difference(P<0.001).In addition,the average length of stay was shorter in the experimental group than that in the control group,with statistically significant difference(P<0.05).Conclusion For patients with STEMI after emergency PCI,the phase I cardiac rehabilitation treatment can improve cardiac function and quality of life,shorten the length of stay and reduce the incidence of MACE.