运动训练对急性心肌梗死患者PCI术后运动耐量的影响

Effect of exercise training on exercise tolerance in acute myocardial infarction patients Post-PCI

目的探讨运动训练(ET)对急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后运动耐量的改善作用,以期为临床相关干预提供参考。方法选取2022年10月─2023年10月于遂宁市中心医院心内科诊断为AMI并行PCI术的40例患者为研究对象,将患者随机分为对照组与干预组,每组20例。2组患者均予以常规药物治疗,干预组在此基础上给予ET干预。比较2组患者干预前(T_(0))后[干预后4周(T_(1))、干预后8周(T_(2))、干预后12周(T_(3))]峰值摄氧量(VO_(2peak))、无氧阈代谢当量、二氧化碳通气当量斜率(VE/VCO_(2) slope)、心输出量(CO)、心脏指数(CI)、每搏输出量(SV)、每搏输出指数(SVI)及简明生活质量量表(SF-36)、Borg评分。结果干预组患者T_(1)、T_(2)、T_(3)时VO_(2peak)均高于T0,且干预组患者T3时VO2peak高于对照组,差异均有统计学意义(P<0.05)。干预组患者T_(2)、T_(3)时无氧阈代谢当量均高于T_(0),且高于同时间点对照组,差异均有统计学意义(P<0.05)。对照组患者干预后T1时无氧阈代谢当量低于T_(0),差异有统计学意义(P<0.05)。2组患者干预前后不同时间点VE/VCO_(2) slope组内及组间比较,差异均无统计学意义(P>0.05)。干预组患者T_(3)时CO高于T_(0),且高于同时间点对照组,差异均有统计学意义(P<0.05)。干预组患者T3时CI高于T0,且高于同时间点对照组,差异有统计学意义(P<0.05)。干预组患者T_(3)时SV高于T_(0),且T_(1)、T_(2)、T_(3)时均高于对照组,差异均有统计学意义(P<0.05)。干预组T_(3)时SVI值高于T_(0),且高于同时间点对照组,差异均有统计学意义(P<0.05)。2组患者不同时间点SF-36评分均高于T_(0),且T_(2)、T_(3)时干预组高于对照组,差异均有统计学意义(P<0.05)。2组患者不同时间点Borg评分均低于T_(0),且干预组低于同时间点对照组,差异均有统计学意义(P<0.05)。结论ET对AMI患者PCI术后运动耐量有明显的改善作用,同时可提高患者生活质量,值得临床推广应用。

Objective To explore the effect of exercise training(ET)on improving exercise tolerance in acute myocardial infarction(AMI)patients after percutaneous coronary intervention(PCI),providing reference for clinical interventions.Methods Overall,40 patients diagnosed with AMI and undergoing PCI at Suining Central Hospital between October 2022 and October 2023 were selected.Patients were randomly allocated to control and intervention groups,each with 20 patients.Both groups received standard medication,while the intervention group additionally received ET intervention.Exercise tolerance was assessed at different time points[T_(0),4 weeks(T_(1)),8 weeks(T_(2)),and 12 weeks(T_(3))post-intervention]using peak oxygen uptake(VO_(2peak)),anaerobic threshold metabolic equivalents,slope of ventilatory equivalent for carbon dioxide(VE/VCO_(2) slope),cardiac output(CO),cardiac index(CI),stroke volume(SV),stroke volume index(SVI),as well as the 36-Item Short-Form Health Survey(SF-36)quality of life scale and Borg scores.Results The intervention group showed significantly higher VO_(2peak) at T_(1),T_(2),and T_(3) compared to T_(0),and VO_(2peak) at T_(3) was significantly higher than that in the control group(P<0.05).Anaerobic threshold metabolic equivalents were significantly higher in the intervention group at T_(2) and T_(3) compared to T_(0) and the control group at the same time points(P<0.05).The control group showed significantly lower anaerobic threshold metabolic equivalents at T_(1) compared to T0(P<0.05).No significant differences were observed in VE/VCO_(2) slope within and between groups(P>0.05).CO and CI were significantly higher in the intervention group at T_(3) compared to T_(0) and the control group at the same time points(P<0.05).SV was significantly higher in the intervention group at T_(3) compared to T_(0) and the control group at T_(1),T_(2),and T_(3)(P<0.05).SVI was significantly higher in the intervention group at T_(3) compared to T_(0) and the control group at the same time points(P<0.05).The SF-36 scores at different time points in the two groups were significantly higher than T_(0),and the intervention group was significantly higher than the control group at T_(2) and T_(3)(P<0.05).Borg scores at different time points in the two groups were significantly lower than T_(0),and the intervention group was significantly lower than the control group at the same time point(P<0.05).Conclusion ET significantly improves exercise tolerance in AMI patients post-PCI,and raises their quality of life,making it worthy of clinical application.