心脏康复综合管理在冠心病PCI术后患者中的应用

Application of comprehensive management of cardiac rehabilitation in patients with coronary heart disease after PCI

目的:探讨心脏康复综合管理在冠心病经皮冠脉介入治疗(PCI)术后患者中的应用价值及对预后的影响。方法:选本院就诊并接受PCI的冠心病患者180例,随机分为常规治疗组和心脏康复组,各90例。比较两组患者在出院时以及随访6个月的危险因素控制情况,简明健康状况调查表(SF-36)评分、心功能的指标,6min步行的距离(6MWD)、心绞痛发作频率及主要心血管不良事件(MACE)的发生率。结果:6个月后,与常规治疗组比较,心脏康复组血压(53.3%比75.6%)及血脂达标率(46.7%比67.8%)、SF-36评分[(59.9±5.1)分比(63.8±1.8)分]、6MWD[(362.3±47.7)m比(416.7±39.1)m]、LVEF[(59.9±6.0)%比(63.6±4.7)%]均显著增加,心绞痛发作次数显著减少[(1.6±0.5)次比(1.1±0.7)次],LVEDd[(33.8±4.5)mm比(28.8±6.6)mm]显著缩小(P均<0.01)。结论:心脏康复综合管理有助于控制冠心病的危险因素,显著改善患者生活质量、运动量、心功能,值得推广。

Objective:To explore application value of comprehensive management of cardiac rehabilitation(CR)in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI)and its influence on prognosis.Methods:A total of 180 CHD patients,who were treated in our hospital and received PCI,were randomly and equally divided into routine treatment group and CR group.Risk factor control,score of the medical outcomes study 36-item short-form heath survey(SF-36),cardiac function indexes,6-minute walking distance(6MWD),angina pectoris attack frequency and incidence rate of major adverse cardiovascular events(MACE)were compared between two groups at discharge and six months after follow-up.Results:After six months,compared with routine treatment group,there were significant rise in standard-reaching rates of blood pressure(53.3%vs.75.6%)and blood lipid(46.7%vs.67.8%),SF-36 score[(59.9±5.1)scores vs.(63.8±1.8)scores],6MWD[(362.3±47.7)m vs.(416.7±39.1)m]and LVEF[(59.9±6.0)%vs.(63.6±4.7)%],and significant reductions in onset times of angina pectoris[(1.6±0.5)times vs.(1.1±0.7)times]and LVEDd[(33.8±4.5)mm vs.(28.8±6.6)mm]in CR group,P<0.01 all.Conclusion:Comprehensive management of cardiac rehabilitation is helpful to control related risk factors of CHD,significantly improve the quality of life,exercise amount and cardiac function in patients,which is worth extending.