阶段性心脏康复训练对急性冠脉综合征合并心力衰竭患者经皮冠状动脉介入治疗术后康复的影响  

Effect of staged cardiac rehabilitation training on the rehabilitation of patients with acute coronary syndrome complicated with heart failure after percutaneous coronary intervention

作　　者：孙秋[1] 王治[1] 杜军 谢红萍[1] 李金銮[1] Sun Qiu;Wang Zhi;Du Jun;Xie Hongping;Li Jinluan(Department of Cardiology,Nanjing Chest Hospital,Nanjing 210029,China)

机构地区：[1]南京市胸科医院心内科,南京210029

出　　处：《中国医学前沿杂志（电子版）》2021年第1期80-84,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家自然科学基金(81570365)。

摘　　要：目的分析阶段性心脏康复训练对急性冠脉综合征(acute coronary syndrome,ACS)合并心力衰竭患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后康复的影响。方法选择2018年2月至2020年5月南京市胸科医院心内科收治的ACS合并心力衰竭患者122例为研究对象,将患者进行编号,奇数编号者纳入常规训练组,偶数编号者纳入阶段训练组,每组各61例。两组患者均行PCI,常规训练组患者术后接受常规心脏康复训练,阶段训练组患者术后接受阶段性心脏康复训练。比较两组患者PCI术后1周和3个月血清炎性因子、心功能、运动功能、生活质量,分析阶段性心脏康复训练对患者预后的影响。结果两组患者术后3个月血清高敏C反应蛋白(high-sensitivity C reactive protein,hs-CRP)、白介素-6(interleukin-6,IL-6)、白介素-10(interleukin-10,IL-10)、内皮素-1(endothelin-1,ET-1)和肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)水平均显著低于本组术后1周(均P<0.05),左室射血分数(left ventricular ejection fraction,LVEF)、心输出量(cardiac output,CO)和世界卫生组织生存质量测定量表简表(World Health Organization quality of life-brief version,WHOQOL-BREF)各领域评分及总分均显著高于本组术后1周(均P<0.05),6 min步行距离均显著长于本组术后1周(均P<0.05)。阶段训练组患者术后3个月血清hs-CRP、IL-6、IL-10、ET-1、TNF-α水平均显著低于常规训练组(均P<0.05),LVEF、CO和WHOQOL-BREF各领域评分及总分均显著高于常规训练组(均P<0.05),6 min步行距离显著长于常规训练组(P<0.05)。结论与常规心脏康复训练相比,阶段性心脏康复训练能够进一步促进ACS合并心力衰竭患者PCI术后血清炎性因子、心功能、运动功能和生活质量的改善。Objective To analyze the effect of staged cardiac rehabilitation training on the rehabilitation of patients with acute coronary syndrome(ACS)complicated with heart failure after percutaneous coronary intervention(PCI).Method A total of 122 patients with ACS complicated with heart failure admitted to the Department of Cardiology of Nanjing Chest Hospital from February 2018 to May 2020 were numbered,those with odd numbers were included in routine training group,and those with even numbers were included in stage training group,with 61 cases in each group.All patients were treated with PCI.Patients in routine training group received routine cardiac rehabilitation training,while patients in stage training group received staged cardiac rehabilitation training.The changes of inflammatory factors,cardiac function,motor function and quality of life were compared between the two groups 1 week and 3 months after PCI,and the influence of staged cardiac rehabilitation on the prognosis of patients was analyzed.Result At 3 months after surgery,the serum levels of high-sensitivity C reactive protein(hs-CRP),interleukin-6(IL-6),interleukin-10(IL-10),endothelin-1(ET-1)and tumor necrosis factor-α(TNF-α)in the two groups were significantly lower than those in the same group at 1 week after surgery(all P<0.05),the left ventricular ejection fraction(LVEF),cardiac output(CO)and World Health Organization quality of life-brief version(WHOQOL-BREF)scores in various fields and total score were significantly higher than those in the same group at 1 week after surgery(all P<0.05),and the 6 min walk distances were significantly longer than those in the same group at 1 week after surgery(all P<0.05).At 3 months after surgery,the serum hs-CRP,IL-6,IL-10,ET-1,TNF-αlevels of patients in stage training group were significantly lower than those in routine training group(all P<0.05),the LVEF,CO and WHOQOL-BREF scores in various fields and total score were significantly higher than those in routine training group(all P<0.05),the 6 min walking dist

关 键 词：阶段性心脏康复训练 急性冠脉综合征 心力衰竭 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]