多维度心脏康复模式对急性心肌梗死PCI术后患者预后及Lp-PLA_(2)的影响

Effect of multidimensional cardiac rehabilitation model on prognosis and Lp-PLA_(2) in patients with acute myocardial infarction after PCI

目的 探讨多维度心脏康复模式对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗术(PCI)术后心功能、生活质量及血浆脂蛋白相关磷脂酶A_(2)(Lp-PLA_(2))的影响。方法 选取2021年1—10月于蚌埠市第二人民医院行PCI治疗的AMI患者234例,按照随机数字表法分为对照组和观察组各117例,对照组进行一般心脏康复模式干预,观察组行多维度心脏康复模式干预。比较2组患者干预前、干预6个月及12个月后的心功能,包括左室射血分数(LVEF)、6 min步行距离(6MWD)、不良心血管事件(MACE)、简明健康调查量表(SF-36)评分、健康问卷-9项(PHQ-9)评分及Lp-PLA_(2)水平。结果 干预6个月及12个月后,2组患者的LVEF、6MWD等均高于干预前,且观察组各指标均显著优于对照组(均P<0.05)。2组患者的SF-36评分均高于干预前,PHQ-9评分均低于干预前,且观察组相比对照组差异有统计学意义(均P<0.05)。干预12个月后观察组Lp-PLA_(2)水平显著低于对照组(282.54±21.82 vs. 318.66±12.89,t=243.340,P<0.001)。结论 AMI患者PCI术后多维度心脏康复模式能够降低血管粥样硬化斑块破裂的风险,有效改善其心功能,降低不良心血管事件发生率,提高生活质量。

Objective To investigate the effects of multidimensional cardiac rehabilitation model on cardiac function,quality of life and plasma lipoprotein-associated phospholipase A_(2)(Lp-PLA_(2))in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 234 AMI patients who underwent PCI in the Second People's Hospital of Bengbu from January to October 2021 were selected and divided into control group and observation group according to the random number table method,with 117 cases in each group.The control group received general cardiac rehabilitation model intervention,and the experimental group received multidimensional cardiac rehabilitation model intervention.Cardiac function,including left ventricular ejection fraction(LVEF),six-minute walking distance(6MWD),major adverse cardiovascular events(MACE),36-item short-form(SF-36)score,patient health questionnaire-9(PHQ-9)score and Lp-PLA_(2)level were compared between the two groups before intervention,6 months and 12 months after intervention.Results After 6 months and 12 months of intervention,the LVEF and 6MWD of the two groups were higher than those before intervention,and the indexes of the experimental group were significantly better than those of the control group(all P<0.05).The SF-36 scores of the two groups were higher than those before intervention,the PHQ-9 scores were lower than those before intervention,and there was significant difference between the experimental group and the control group(all P<0.05).After intervention,the level of Lp-PLA_(2)in the experimental group was significantly lower than that in the control group(282.54±21.82 us.318.66±12.89,t=243.340,P<0.001).Conclusion The multidimensional cardiac rehabilitation model after PCI in AMI patients can reduce the risk of atherosclerotic plaque rupture,effectively improve their cardiac function,reduce adverse cardiovascular events,and improve their quality of life.