八段锦对急性心肌梗死PTCA术后Ⅰ期康复的影响研究  

Study on the effect of Baduanjin exercise on the stageⅠrehabilitation of acute myocardial infarction after PTCA

作　　者：张亚菲[1] 刘旸[1] 韩雅蕾[1] 翁浩[1] 张萌[1] ZHANG Yafei;LIU Yang;HAN Yalei;WENG Hao;ZHANG Meng(Aerospace Center Hospital, Beijing 100049, China)

机构地区：[1]航天中心医院,北京100049

出　　处：《现代中西医结合杂志》2021年第7期719-724,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：航天中心医院院级课题(YN201606);首都临床特色应用研究项目(Z181100001718065)。

摘　　要：目的探讨八段锦对急性心肌梗死患者经皮冠状动脉腔内血管成形术(PTCA)后Ⅰ期心脏康复的影响。方法选取2018年10月—2019年10月于航天中心医院心脏医学中心住院的急性心肌梗死后成功接受PTCA手术、低-中危GRACE评分患者84例,随机分为实验组43例和对照组41例。实验组在PTCA术后第1~5天进行改良八段锦训练,第6~14天进行常规八段锦训练;对照组术后第1~14天逐步进行床上被动活动、床旁站立、室内步行等活动。记录2组患者治疗前及治疗5 d、14 d后静息心血管反应参数[晨起进食前安静状态下的心率(HR)、收缩压(SBP)、两项乘积(RPP)]、中国心血管病人生活质量评定问卷(CQQC)评分;检测2组治疗前及治疗14 d后超声心动图指标[左室射血分数(LVEF)、左室舒张末期内径(LVDd)]、血清氨基末端B型钠尿肽原(NT-proBNP)水平;治疗14 d后进行心肺运动试验,计算代谢当量(MET);统计2组治疗期间主要心血管不良事件。结果治疗5 d后,实验组HR、SBP、RPP均明显降低(P均<0.05),2组CQQC评分均明显升高(P均<0.05),且治疗14 d后实验组上述指标及对照组CQQC评分改善情况均优于治疗5 d后(P均<0.05);组间比较,实验组治疗5 d、14 d后的HR、RPP和治疗14 d后的SBP均明显低于同期对照组(P均<0.05),治疗5 d、14 d后的CQQC评分均明显高于同期对照组(P均<0.05)。治疗14 d后,2组患者LVEF、LVDd均无明显变化(P均>0.05),2组患者血清NT-proBNP水平均明显降低(P均<0.05),且实验组明显低于对照组(P<0.05);治疗14 d后,实验组MET明显高于对照组(P<0.05)。治疗中2组均无严重不良心血管事件发生。结论八段锦能够安全有效地提高PTCA术后Ⅰ期康复患者的心脏功能和运动耐力,改善患者生活质量。Objective It is to investigate the effect of Baduanjin exercise on the stage I cardiac rehabilitation of patients with acute myocardial infarction after percutaneous transluminal coronary angioplasty(PTCA).Methods 84 patients with acute acute myocardial infarction who had successfully undergone PTCA surgery in the Heart Medicine Center of Aerospace Center Hospital with low-medium risk GRACE scores from October 2018 to October 2019 were randomly divided into experimental group(n=43)and control group(n=41).The experimental group received modified Baduanjin exercise on the 1st to 5th day after PTCA,and routine Baduanjin exercise on the 6th to 14th days after PTCA;the control group gradually performed some exercise followed by passive bed movement,bedside standing,room walking on the 1st to 14th day after PTCA.The resting cardiovascular response parameters[heart rate(HR),systolic blood pressure(SBP)and their product(RPP)in a resting state before eating in the morning],Chinese Questionnaire of Quality of Life in Chinese Patients with Cardiovascular Disease(CQQC)scores of the patients in both groups were recorded before treatment and after 5,14 days of treatment;the echocardiography indexes[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVDd)],levels of serum amino-terminal pro-B-type natriuretic peptide(NT-proBNP)of the patients in both groups were detected before treatment and 5 d and 14 d after treatment;cardiopulmonary exercise test was performed 14 days after treatment to calculate the metabolic equivalent(MET);the main adverse cardiovascular events during the treatment of the 2 groups were counted.Results After 5 days of treatment,the HR,SBP,and RPP of the experimental group were significantly reduced(all P<0.05),and the CQQC scores of the two groups were significantly increased(all P<0.05).After 14 days of treatment,the improvements of the above indicators of the experimental group and the CQQC score of the control group were better than those after 5 days of treatment(all P<0.0

关 键 词：八段锦 Ⅰ期心脏康复 经皮冠状动脉腔内血管成形术 

分 类 号：R541.4[医药卫生—心血管疾病]