冠心病PCI术后抑郁焦虑患者心脏康复的对比研究  

Comparison in cardiac rehabilitation in patients with coronary heart disease and post-operative depression-anxiety after PCI

作　　者：盖延红[1] 栾晓东[2] 李越凡 朱为勇 Gai Yanhong;Luan Xiaodong;Li Yuefan;Zhu Weiyong(Department of Cardiovascular Medicine,Second College of Clinical Medicine,Qingdao University,Qingdao 266042,China)

机构地区：[1]青岛大学第二临床医学院心血管内科,青岛266042 [2]青岛大学第二临床医学院乳腺外科,青岛266042

出　　处：《中国循证心血管医学杂志》2018年第10期1244-1246,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的观察心脏康复运动方案对冠状动脉粥样硬化性性心脏病(冠心病)经皮冠状动脉介入术(PCI)后合并抑郁焦虑患者生活质量的影响。方法将青岛市中心医院心内科于2016年12月～2017年12月收治的169例冠心病PCI后通过焦虑抑郁量表测定确诊为抑郁和焦虑的患者随机分为心脏康复组(n=83)和对照组(n=86),两组患者均接受常规治疗,心脏康复组在上述基础上给予运动训练及心理干预。180 d后进行6 min步行试验(6MWT)、左室射血分数(LVEF)、B型脑钠肽(BNP)测定、并再次给予焦虑自评量表(SAS)和抑郁自评量表(SDS)评定,对不良心血管事件发生率进行比较。再将心脏康复组根据运动频次分为3组,分别为3次/周组,4次/周组,5次/周组,比较心功能和焦虑抑郁指标变化。结果心脏康复组与对照组相比SAS和SDS评分明显降低。6 min步行试验及LVEF及BNP明显优于对照组,不良事件发生率明显下降。较多运动频次对6 min步行试验和LVEF有提高(P<0.05),但对焦虑抑郁状态改善不明显。结论心脏康复对冠心病PCI术后合并焦虑抑郁患者效果改善明显,具有临床意义。Objective To observe the influence of cardiac rehabilitation exercise scheme on quality of life(QOL)in patients with coronary heart disease(CHD)complicated by post-operative depression-anxiety after percutaneous coronary intervention(PCI).Methods CHD patients(n=169),diagnosed as depression-anxiety ones with anxiety and depression scales,were chosen from Department of Cardiology of Central Hospital of Qingdao City from Dec.2016 to Dec.2017,and then randomly divided into cardiac rehabilitation group(n=83)and control group(n=86).The two groups were given routine treatment,and cardiac rehabilitation group was additionally given exercise training and psychological intervention.After 180 d,6-minute walk test(6MWT),left ventricular ejection fraction(LVEF)and B-type natriuretic peptide(BNP)were detected.All patients were given once again determinations of self-rating anxiety scale(SAS)and self-rating depressive scale(SDS).The incidence of major adverse cardiovascular events(MACE)was compared between 2 groups.The cardiac rehabilitation group were divided further,according to exercise frequency,into 3 groups,3 times/week group,4 times/week group and 5 times/week group.The changes of heart functional indexes and depression-anxiety indexes were compared.Results The scores of SAS and SDS decreased significantly in cardiac rehabilitation group compared with control group.The results of 6MWT,LVEF and BNP were significantly better,and incidence of MACE decreased significantly in cardiac rehabilitation group compared with control group.6MWT and LVEF were improved by more exercise frequency(P<0.05),but depression-anxiety status was not improved significantly.Conclusion Cardiac rehabilitation has significant improving effect in patients with CHD complicated by post-operative depressionanxiety after PCI in clinical practice.

关 键 词：冠心病 焦虑抑郁 心脏康复 

分 类 号：R541.4[医药卫生—心血管疾病]