急性心肌梗死患者于心脏康复中心就诊的影响因素及效果评价  

Study on influencing factors and effect evaluation of patients with acute myocardial infarction in the cardiac rehabilitation center

作　　者：许莉[1,2] 杨艳 陈菡芬 姜萌 卜军[1] XU Li;YANG Yan;CHEN Hanfen;JIANG Meng;PU Jun(Department of Cardiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Shanghai Jiao Tong University School of Nursing,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属仁济医院心内科,上海200127 [2]上海交通大学护理学院,上海200025

出　　处：《上海交通大学学报（医学版）》2022年第5期646-652,共7页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家重点研发计划(2018YFC1312802)。

摘　　要：目的·分析急性心肌梗死(acute myocardial infarction,AMI)患者在心脏康复中心(cardiac rehabilitation center,CRC)就诊的相关影响因素,并对康复效果进行评价,从而为心脏康复工作的有效开展提供依据。方法·选择2020年5月—2021年10月在上海交通大学医学院附属仁济医院接受急诊经皮冠状动脉介入治疗的中、高危AMI患者454例,收集并分析其一般人口学资料、疾病情况等。根据患者是否选择于CRC就诊,将其分为2组。采用Logistic回归模型对可能影响AMI患者于CRC就诊的相关因素进行分析,并比较患者出院后第1次至CRC就诊前和就诊3个月后的心肺功能及体脂测量变化。结果·共有32例(7.05%)患者(组1)在出院后选择于CRC就诊,其余患者(组2)未选择。一般人口学资料和疾病情况的分析显示,年龄、宗教信仰、教育背景、工作状态的组间差异均具有统计学意义(均P<0.05)。Logistic回归分析显示,年龄、教育背景(高中或中专、大专及以上)、发生2支心脏血管病变、出院前的心脏彩超左心室射血分数(left ventricular ejection fraction,LVEF)是患者于CRC就诊的保护因素,而有宗教信仰是其危险因素(均P<0.05)。与出院后第1次至CRC就诊前相比,于CRC就诊3个月后的患者的峰值千克摄氧量(t=7.619,P=0.000)和无氧阈的千克摄氧量(t=5.510,P=0.000)均较高,体质量指数(t=3.132,P=0.004)和腰臀比(t=3.891,P=0.000)均有所下降。结论·中、高危AMI患者出院后选择于CRC就诊率仍处于较低水平,且年龄、宗教信仰、教育背景、心脏血管病变情况和出院前的心脏彩超LVEF是该类患者选择CRC就诊的影响因素;于CRC就诊3个月后,患者的心肺功能和体脂方面均有明显改善。Objective·To analyze the relevant influencing factors of patients with acute myocardial infarction(AMI)in the cardiac rehabilitation center(CRC),and evaluate the rehabilitation effect,in order to provide evidence for the effective development of cardiac rehabilitation.Methods·From May 2020 to October 2021,454 patients with moderate and high-risk AMI who received emergency percutaneous coronary intervention in Renji Hospital,Shanghai Jiao Tong University School of Medicine were selected.Their general demographic data and disease situation were collected and analyzed.Patients were divided into two groups based on whether they chose to visit the CRC.Logistic regression model was performed to explore the relevant factors of AMI patients enrolled in CRC,and to compare the changes of cardiopulmonary function and body fat measurement of AMI patients before the first visit to CRC and after 3 months in CRC after discharge.Results·A total of 32(7.05%)patients(group 1)were enrolled in CRC after discharging from ward,and the other patients(group 2)did not.The analysis of general demographic data and disease situation showed that there were significant differences in age,religious belief,educational background and working state(all P<0.05).Logistic regression analysis showed that age,educational background(high school/technical secondary school,college or above),occurrence of two cardiac vascular lesions and left ventricular ejection fraction(LVEF)before discharge were the protective factors of AMI patients enrolled in CRC,while religious belief was the risk factor(all P<0.05).Compared with the indexes before the first visit to CRC,the peak ventilation oxygen per kilogram(t=7.619,P=0.000)and ventilation oxygen in the anaerobic threshold per kilogram(t=5.510,P=0.000)of AMI patients enrolled in CRC 3 months after discharge were higher,while the body mass index(t=3.132,P=0.004)and waist hip rate(t=3.891,P=0.000)were lower.Conclusion·The enrolling percentage of moderate and high-risk AMI patients in CRC is still at a low leve

关 键 词：急性心肌梗死 心脏康复中心 心脏康复 影响因素 效果 

分 类 号：R473.5[医药卫生—护理学]