心脏康复用于急性冠状动脉综合征的疗效及对患者生活质量的影响  

Effect of cardiac rehabilitation on acute coronary syndrome and quality of life

作　　者：康铁朵[1] 刘文娴[1] 康云鹏[1] 任燕龙[1] Kang Tieduo;Liu Wenxian;Kang Yunpeng;Ren Yanlong(Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029. China)

机构地区：[1]首都医科大学附属北京安贞医院心内科北京市心肺血管疾病研究所,100029

出　　处：《中国医药》2018年第6期814-817,共4页China Medicine

基　　金：北京市自然科学基金(7184205);北京市卫生和计划生育委员会北京市卫生与健康科技成果和适宜技术推广项目(TC-2017-34)~~

摘　　要：目的观察心脏康复用于急性冠状动脉综合征(ACS)的疗效及对患者生活质量的影响。方法选取2016年1月至2017年2月首都医科大学附属北京安贞医院收治的93例ACS患者,按随机数字表法分为对照组(46例)和观察组(47例)。对照组给予规范化冠状动脉粥样硬化性心脏病二级预防治疗;观察组在对照组的基础上加用心脏康复治疗,6个月为1个疗程。比较2组疗效、心功能、6 min步行距离(6MWD)、心肺运动试验(CPET)指标、SF-36健康状况调查量表生活质量评分。结果观察组总有效率明显高于对照组[68.1%(32/47)比41.3%(19/46)],差异有统计学意义(P<0.05)。治疗后,对照组心功能和6MWD无明显改善,观察组左心室射血分数、6MWD明显高于/长于治疗前和对照组[(48±4)%比(42±5)%、(42±6)%,(359±50)m比(280±35)、(303±33)m],差异均有统计学意义(均P<0.05)。治疗后,2组CPET各指标均有不同程度改善,观察组用力肺活量、无氧阈摄氧量、峰值功率及峰值氧脉搏明显高于对照组,差异均有统计学意义(均P<0.05)。治疗后,2组SF-36量表评分均有不同程度改善,组间比较,观察组生理机能、一般健康、精力、精神健康及总分明显高于对照组,差异均有统计学意义(均P<0.05)。结论心脏康复能明显改善ACS患者心肺功能、运动能力和生活质量。Objective To observe the effect of cardiac rehabilitation on acute coronary syndrome（ACS） and quality of life. Methods A total of 93 ACS patients admitted in Beijing Anzhen Hospital, Capital Medical University from January 2016 to February 2017 were randomly divided into control group（n＝46） and observation group（n＝47）. The control group had secondary preventive therapy of coronary heart disease; the observation group had cardiac rehabilitation additionally, with 6 months for a course of treatment. Therapeutic effect, heart function, 6 min walking distance （6MWD）, results of cardiopulmonary exercise test and the SF-36 score were analyzed. Results Total effective rate in observation group was significantly higher than that in control group［68.1%（32/47） vs 41.3%（19/46）］（P＜0.05）. After treatment, heart function and 6MWD in control group showed no significant improvements; left ventricular ejection fraction and 6MWD in observation group were significantly higher/longer than those before treatment and those in control group［（48±4）% vs（42±5）%,（42±6）%; （359±50）m vs（280±35）,（303±33）m］（P＜0.05）. After treatment, forced vital capacity, anaerobic threshold oxygen consumption, peak respiratory power and peak oxygen pulse in observation group were significantly higher than those in control group（P＜0.05）. After treatment, scores of physiological function, general health, vigor, mental health and the total SF-36 score in observation group were significantly higher than those in control group（P＜0.05）. Conclusion Cardiac rehabilitation can effectively improve cardiopulmonary function, athletic performance and quality of life in ACS patients.

关 键 词：急性冠状动脉综合征 心脏康复 心肺功能 生活质量 

分 类 号：R541[医药卫生—心血管疾病]