康复训练对冠状动脉支架术后近期预后的影响  

Effect of rehabilitation training on short-term prognosis of patients after coronary stenting

作　　者：朱升四[1] 方唯一[1] 刘俊[1] 潘晓杰[1] 王艾联[1] 洪丽[1] 

机构地区：[1]大连医科大学附属第一医院,辽宁大连116011

出　　处：《心血管康复医学杂志》2008年第2期101-104,117,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：研究康复训练能否减少冠脉支架术后心脏事件的发生率。方法：连续收集冠状动脉支架术患者,术后行平板运动心电图试验（test of exercise ECG,TE-ECG）,分为两组,康复组进行康复训练指导;另一组不进行康复训练指导,其后随访6个月。对两组的心脏事件发生率进行比较,应用单因素分析和多变量回归分析,得出冠状动脉支架术后近期心脏事件发生的独立影响因素。结果：单因素分析：12个变量出现统计学差异;多变量分析：冠心病可能值≥0.85（OR=1.61,95%CI=0.89-2.13,P=0.01）、支架数目≥2个（OR=1.85,95%CI=0.95-2.26,P=0.04）、总运动时间〈5min（OR=1.66,95%CI=0.91-2.21,P=0.001）、最大ST/HR斜率〉2.5（OR=3.16,95%CI=2.21-3.58,P=0.001）、康复训练（OR=0.58,95%CI=0.46-1.23,P=0.03）留在回归方程中。结论：应用TE-ECG对患者进行康复训练的指导能减少冠脉支架术术后半年内的心脏事件发生率。Objective To study whether rehabilitation training can reduce short-term cardiac events of patients who successfully adopted coronary stenting. Methods Successively collected patients who were conducted＂ coronary stenting and asked them to finish exercise stress electrocardiograph test 1 to 2 months after interventional procedures. Randomly divided them into two groups. One group got rehabilitation training （rehabilitation group） and another group not（controlled group）. Collect six-month-follow-up data on their cardiac events. Used univariate and multivariate analysis as main statistic methods. Results （1） Univariate analysis. Twelve variables had significant effect on cardiac event; （2） Multivariate analysis Five variables, which were prengiograhic likelihood of coronary artery disease （CAD） 0.85, number of stents implanted≥2 total exercise time〈5 min, maximal ST/HR slope〉2.5 （V/beat min） and the factor of rehabilitation training were remained in the regression equation. Conclusion Rehabilitation training guided by exercise test of ECG can reduce short-term cardiac events of patients who adopted coronary stenting. Pre-angiograhic likelihood of CAD≥0.85, number of stents implanted≥2, total exercise time〈5 min and maximal ST/HR slope〉2.5 （V/beat min） were risk factors of cardiac events for the patients with coronary stenting.

关 键 词：冠状动脉疾病 血管成形术 经腔 经皮冠状动脉 康复 预后 

分 类 号：R541.409[医药卫生—心血管疾病]