心脏康复治疗对急性冠状动脉综合征患者经皮冠状动脉介入术术后心功能及预后影响

Effect of cardiac rehabilitation on cardiac function and prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

目的探讨心脏康复治疗对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)术后心功能及预后的影响。方法采用回顾性分析法,选取2019年6月至2021年8月景德镇市第一人民医院收治的120例ACS患者作为研究对象,按治疗方法的不同分为对照组和试验组,每组各60例。对照组PCI后给予常规治疗,试验组在对照组的基础上再给予心脏康复治疗,12周为1个治疗期,比较两组治疗期内不同治疗方法对患者心脏功能[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)]、生活质量(西雅图心绞痛量表)、运动耐力[最大摄氧量(VO_(2 max))、最大心率(HR_(max))、6 min步行距离(6MWT)、代谢当量(METs)]、心血管事件(MACE)发生率的影响。结果治疗前两组LVEDD、LVEF比较,差异无统计学意义(P>0.05),治疗后试验组的LVEDD低于对照组,LVEF高于对照组,差异有统计学意义(P<0.05)。干预后试验组生活质量评分高于对照组,差异有统计学意义(P<0.05)。治疗前两组VO_(2 max)、HR_(max)、6MWT、METs比较,差异无统计学意义(P>0.05),治疗后试验组的VO_(2 max)、6MWT、METs高于对照组,HR_(max)低于对照组,差异有统计学意义(P<0.05)。治疗期间试验组的MACE发生率低于对照组,差异有统计学意义(P<0.05)。结论ACS患者PCI术后给予心脏康复治疗能够提高心功能、生活质量、运动耐力,且能降低心血管事件发生率。

Objective To investigate the effect of cardiac rehabilitation on cardiac function and prognosis of patients with acute coronary syndrome(ACS)after the percutaneous coronary intervention(PCI).Methods The retrospective analysis was adopted.A total of 120 ACS patients who were admitted to Jingdezhen First People′s Hospital from June 2019 to August 2021 were selected as the research objects and divided into the control group and the experimental group according to the different treatment methods,with 60 patients in each group.The control group was given routine treatment after PCI,and the experimental group was given cardiac rehabilitation therapy on the basis of the control group,with 12 weeks as a treatment period.The cardiac function(left ventricular end-diastolic diameter[LVEDD],left ventricular ejection fraction[LVEF]),quality of life(Seattle Angina scale),exercise tolerance(maximum oxygen uptake[VO_(2 max)],maximum heart rate[HR_(max)],6-minute walking distance[6MWT],metabolic equivalent[METs]),and incidence of major adverse cardiovascular events(MACE)were compared between two groups during the treatment period.Results Before treatment,there were no statistically significant differences in LVEDD and LVEF between the two groups(P>0.05).After treatment,the LVEDD and LVEF in the experimental group were better than those in the control group,and the differences were statistically significant(P<0.05).After intervention,the score of quality of life in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,no differences were observed in the VO_(2 max),HR_(max),6MWT and METs between the two groups(P>0.05).After treatment,the VO_(2 max),6MWT and METs in the experimental group were higher than those in the control group,and the HR_(max) in experimental group was lower han that in the control group, with statistically significant differences (P<0.05). During the treatment, the incidences of MACE in the experimental group were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusion Cardiac rehabilitation after PCI for ACS patients can improve cardiac function, quality of life and exercise tolerance, and reduce the incidence of cardiovascular events.