新型心脏康复训练对急性ST段抬高型心肌梗死患者PCI术后心功能及血管内皮功能的影响  

Effect of new-type cardiac rehabilitation training on cardiac function and vascular endothelial function of patients with ST-segment elevation myocardial infarction after PCI

作　　者：韦颖[1] 莫昌干[1] 韦利元[1] 贝晓娜 赖冬艳 唐秀革[1] Wei Ying;Mo Changgan;Wei Liyuan;Bei Xiaona;Lai Dongyan;Tang Xiuge(Department of Cardiology,People's Hospital of Hechi City,Hechi 547000,China)

机构地区：[1]河池市人民医院心血管内科,河池547000

出　　处：《国际医药卫生导报》2023年第4期537-541,共5页International Medicine and Health Guidance News

基　　金：河池重点研发计划项目(河科AB200724)。

摘　　要：目的探讨新型心脏康复训练对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后心功能及血管内皮功能的影响。方法选取河池市人民医院60例行PCI术的急性STEMI患者进行前瞻性研究,随机数字表法分为观察组和对照组,各30例。对照组男19例、女11例,年龄(58.69±6.78)岁,开展传统心脏康复训练;观察组男21例、女9例,年龄(59.33±7.08)岁,在对照组基础上联合新型心脏康复训练。比较两组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、6 min步行试验(6MWT)、内皮素(ET-1)、一氧化氮(NO)及不良事件发生率。统计学方法采用χ^(2)检验、t检验。结果观察组术后LVESD、LVEDD低于对照组[(34.17±2.86)mm比(38.24±2.73)mm、(47.18±3.32)mm比(50.36±2.13)mm],LVEF、6MWT高于对照组[(59.06±3.37)%比(54.36±3.74)%、(457.16±88.49)m比(409.32±79.78)m],差异均有统计学意义(t=4.028、2.817、4.883、3.384,均P<0.05)。观察组术后ET-1水平低于对照组(t=5.728,P<0.05),NO水平高于对照组(t=4.132,P<0.05)。观察组不良心血管事件发生率为10.00%(3/30),低于对照组[30.00%(9/30)],差异有统计学意义(χ^(2)=4.812,P=0.028)。结论新型心脏康复训练有助于改善急性STEMI患者PCI术后心功能及血管内皮功能,降低不良心血管事件发生率。Objective To evaluate the effect of new-type cardiac rehabilitation training on cardiac function and vascular endothelial function of patients with acute ST-segment elevation myocardial infarction(STEMI)after PCI.Methods Sixty patients with acute STEMI treated by PCI at People's Hospital of Hechi City were divided into an observation group and a control group by the random number table method,with 30 cases in each group.There were 19 males and 11 females in the control group;they were(58.69±6.78)year old.There were 21 males and 9 females in the observation group;they were(59.33±7.08)year old.The control group did traditional cardiac rehabilitation training;in addition,the observation group took the new-type cardiac rehabilitation training.The left ventricular end-systolic dimensions(LVESD),left ventricular end diastolic dimensions(LVEDD),left ventricular ejection fractions(LVEF),6 min walking test(6MWT),endothelin(ET-1),NO,and incidences of adverse events were compared between the two groups.χ^(2) and t tests were applied.Results After PCI,the LVESD and LVEDD were lower and the LVEF and 6MWT were higher in the observation group than in the control group[(34.17±2.86)mm vs.(38.24±2.73)mm,(47.18±3.32)mm vs.(50.36±2.13)mm,(59.06±3.37)%vs.(54.36±3.74)%,and(457.16±88.49)m vs.(409.32±79.78)m],with statistical differences(t=4.028,2.817,4.883,and 3.384;all P<0.05).After PCI,the ET-1 level was higher and the NO level was lower in the observation group than in the control group(t=5.728 and 4.132;both P<0.05).The incidence of adverse events in the observation group was lower than that in the control group[10.00%(3/30)vs 30.00%(9/30)],with a statistical difference(χ^(2)=4.812,P=0.028).Conclusion New-type Cardiac rehabilitation training for patients with acute STEMI after PCI can improve their cardiac function and vascular endothelial function and reduce adverse events.

关 键 词：心脏康复训练 急性ST段抬高型心肌梗死 经皮冠状动脉介入 心功能 血管内皮功能 

分 类 号：R542.22[医药卫生—心血管疾病] R493[医药卫生—内科学]