运动康复对经皮冠状动脉介入治疗术后冠心病患者心功能的影响  

Impact of Exercise Rehabilitation on Cardiac Function in Coronary Artery Disease Patients After Percutaneous Coronary Intervention

作　　者：许艳梅[1] 冯玉宝[1] 苏平[1] 李永玲[1] 李长青[1] 乔建晶[1] 

机构地区：[1]鄂尔多斯市中心医院心内科,内蒙古自治区017000

出　　处：《中国循环杂志》2017年第4期326-330,共5页Chinese Circulation Journal

摘　　要：目的:探讨运动康复对经皮冠状动脉介入治疗(PCI)术后冠心病患者心功能的影响。方法:选取2014-01至2015-09期间我院心内科首次行PCI的冠心病不稳定性心绞痛患者130例,按随机分组方法,将其分为常规治疗组和运动康复治疗组,各组65例。两组都给予常规药物治疗及PCI术后常规知识教育,此外,给予运动康复治疗组为期3个月的不同阶段、不同强度的运动康复锻练,再对两组患者心功能[包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、6min步行距离(6MWD)、纽约心脏病协会(NYHA)心功能分级]进行术后1个月、3个月、6个月随访观察和比较。结果:常规治疗组和运动康复治疗组患者入选时的LVEF、LVEDD、6MWD、NYHA心功能分级比较,差异均无统计学意义(P>0.05)。(1)术后1个月时:运动康复治疗组与常规治疗组相比,6MWD差异有统计学意义(P<0.05),LVEF、LVEDD及NYHA心功能分级差异无统计学意义(P>0.05);运动康复组术后1个月与入选时相比,6MWD、NYHA心功能分级差异有统计学意义(P<0.05),而心功能的其余指标差异无统计学意义(P>0.05);常规治疗组术后1个月与入选时比较,6MWD差异有统计学意义(P<0.05),而心功能的其余指标差异无统计学意义(P>0.05)。(2)术后3、6个月时:运动康复治疗组与常规治疗组相比心功能的各项评价指标差异均有统计学意义(P<0.05),运动康复治疗组术后3、6个月较入选时的各项评价心功能指标差异也均有统计学意义(P<0.05);术后3个月时:常规治疗组与入选时相比,LVEDD、6MWD差异有统计学意义(P<0.05);术后6个月时,常规治疗组患者的6MWD与入选时相比差异有统计学意义(P<0.05)。结论:运动康复治疗可以使PCI术后患者的心功能得到改善,从而提高了患者的运动耐力和生活质量。Objective： To explore the impact of exercise rehabilitation on cardiac function in coronary artery disease （CAD） patients after percutaneous coronary intervention （PCI）. Methods： A total of 130 CAD patients received primary PCI in our hospital from 2014-01 to 2015-09 were enrolled. All patients received conventional drug therapy and post-PCI knowledge education, then were randomly divided into 2 groups： Conventional group and Rehabilitation group, in which the patients received cardiac rehabilitation exercise for 3 months at different stage and intensity. n=65 in each group. The cardiac function including left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD）, 6 min walking distance （6MWD） and NYHA classification were compared between 2 groups at 1, 3 and 6 months after the operation. Results： LVEF, LVEDD, 6MWD and NYHA classification were similar between 2 groups at enrollment, P〉0.05. ① At 1 month post-operation： 6MWD was different between 2 groups, P〈0.05, while LVEF, LVEDD, NYHA classification and the recurrence rate of angina pectoris were similar between 2 groups, P〉0.05. In Rehabilitation group, 6MWD and NYHA classification were different from the enrollment condition, P〈0.05, while other parameters were similar, P〉0.05; in Conventional group, 6MWD was different from the enrollment condition, P〈0.05, while other parameters was similar, P〉0.05. ② At 3 and 6 months post-operation： all parameters were different between 2 groups, P〉0.05. In Rehabilitation group, all parameters were different from the enrollment condition, P〈0.05. ③ In Conventional group, at 3 months post-operation： LVEDD and 6MWD were different from the enrollment condition, P〈0.05; at 6 months post-operation： 6MWD was different from the enrollment condition, P〈0.05. Conclusion： Exercise rehabilitation may improve the cardiac function, therefore enhance the endurance capacity and quality of life in CAD patients after PCI.

关 键 词：康复 血管成形术 冠状动脉疾病 心功能试验 

分 类 号：R541.4[医药卫生—心血管疾病]