心脏康复对稳定型心绞痛患者预后的影响  

Effect of cardiac rehabilitation on the prognosis of patients with stable angina pectoris

作　　者：陈美娟[1] 陈汉娜[1] 徐佳[1] 丁家崇[1] 曾令忠[1] 沈丹萍[1] 

机构地区：[1]湖南省马王堆医院心血管内科

出　　处：《中国心血管杂志》2010年第3期193-195,共3页Chinese Journal of Cardiovascular Medicine

基　　金：湖南省卫生医药科研基金项目(B2007168)

摘　　要：目的探讨心脏康复对稳定型心绞痛（SAP）患者预后的影响。方法139例SAP患者随机分成心脏康复治疗组（66例）和对照组（73例），心脏康复组进行踏车运动和常规药物治疗4个月，对照组实行常规药物治疗。测定试验前后血浆C-反应蛋白（CRP）、白介素-6（IL-6）、血栓素A2（TXA2）、低密度脂蛋白胆固醇（LDL—C）水平，并随访两组间心血管事件的发生率。结果两组治疗后较治疗前血浆CRP、IL-6、TXA2、LDL-C水平均有下降；心脏康复组血浆CRP、IL-6水平较常规药物治疗组下降更明显（均为P〈0．05）；两组治疗后均随访1年，心源性死亡、再次急性心肌梗死的发生率差异无统计学意义；心脏康复治疗组需血运重建者更少（6．3％比20．0％）（P〈0．05）。结论心脏康复对SAP患者预后有明显改善；减轻炎症反应可能是改善SAP患者预后的一个重要机制。Objective To study the effect of the cardiac rehabilitation on the prognosis of patients with stable angina pectoris （SAP）. Methods A total of 139 SAP patients were divided randomly into cardiac rehabilitation group and control group. The patients in cardiac rehabilitation group received treadmill and conventional drug treatment for 4 months, and those in control group received routine drug treatment only. The levels of plasma C-reactive protein （CRP）, interleukin-6 （IL-6）, thromboxane A2 （TXA2） and low-density lipoprotein （LDL-C） were compared before and after the experiment. The incidence of cardiovascular events were followed up. Results Though the levels of plasma CRP, IL-6, TXA2 and LDL-C of patients in both groups were decreased after treatment, the levels of plasma CRP, IL-6 of patients in cardiac rehabilitation group were significantly decreased than those in control group （ both P 〈 0. 05 ） . There were no differences in incidences of cardiac death and recurrent acute myocardial infarction when the two groups were followed up for 1 year. Patients required re-hospitalization and revascularization in cardiac rehabilitation group were less （6. 3% vs. 20. 0%, P 〈 0. 05） than in control group. Conclusions Cardiac rehabilitation can significantly improve the prognosis of SAP patients. Reduced inflammatory response might be an important mechanism for this benefit.

关 键 词：心脏 心绞痛 稳定型 预后 心脏康复 

分 类 号：R541.4[医药卫生—心血管疾病]