心脏康复治疗对急性心肌梗死PCI术后ET、vWF水平及预后的影响  

Influence of heart rehabilitation on endothelin,von Willebrand factor and prognosis in patients with acute myocardial infarction after percutaneous coronary intervention

作　　者：谷世奎[1] 朱丹丹 刘虹秀 魏雪梅[1] 王献忠[1] Gu Shikui;Zhu Dandan;Liu Hongxiu;Wei Xuemei;Wang Xianzhong(Second Department of Cardiology,First Hospital of Handan City,Handan 056004,China;不详)

机构地区：[1]邯郸市第一医院心内二科,邯郸056004 [2]邯郸市第一医院肾内二科,邯郸056004

出　　处：《中国循证心血管医学杂志》2023年第6期680-682,688,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省邯郸市科学技术研究与发展计划项目(21422083070)。

摘　　要：目的探讨心脏康复治疗对急性心肌梗死经皮冠脉介入治疗(PCI)术后患者内皮素(ET)、血管性血友病因子(vWF)水平及预后的影响。方法选择2021年9月至2022年3月于邯郸市第一医院就诊的急性心肌梗死PCI术后患者120例,采用随机数表法分为对照组与实验组,每组各60例。对照组患者予以PCI术后常规治疗,实验组在对照组的基础上予以心脏康复治疗;比较两组临床疗效、ET、vWF、心功能[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、6 min步行距离]、Borg劳累度评估量表(Borg)、SF-36简明生活质量评估量表(SF-36)评分水平及不良预后发生情况。结果治疗后,两组总有效率比较差异有统计学意义(P<0.05);两组血清ET、vWF水平均降低,实验组降低更明显(P<0.05);两组LVEF、LVEDD水平均升高,且实验组升高更为明显,实验组6 min步行距离高于对照组(P<0.05);两组临床评分Borg、SF-36水平均降低,实验组较对照组降低更明显(P<0.05);两组患者不良预后主要表现为心力衰竭、心律失常、死亡及再梗死,两组不良预后总发生率比较差异有统计学意义(P<0.05)。结论急性心肌梗死PCI术后患者行心脏康复治疗具有较好疗效,可能与其改善ET、vWF及预后有关。Objective To discuss the influence of heart rehabilitation on endothelin(ET),von Willebrand factor(vWF)and prognosis in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods AMI patients(n=120)undergone PCI were chosen from the First Hospital of Handan City from Sept.2021 to Mar.2022,and all patients were divided into control group and test group(each n=60)by using random digital table.The control group was given routine therapy after PCI and test group was additionally given heart rehabilitation after PCI.The clinical efficacy,ET,vWF,left ventricular ejection fraction(LVEF),left ventricular end-diastolic inner diameter(LVEDD),6-minute walk distance(6MWD),scores of Borg Rating of Perceived Exertion Scale(Borg)and the MOS 36-item Short Form Health Survey(SF-36)and poor prognosis were compared between 2 groups.Results The difference in the total effective rate had statistical significance between 2 group(P<0.05).The levels of ET and vWF decreased in 2 groups,which was more significant in test group(P<0.05).LVEF and LVEDD increased in 2 groups,which was more significant in test group,and 6MWD was higher in test group than that in control group(P<0.05).The scores of Borg and SF-36 decreased in 2 groups,which was more significant in test group(P<0.05).The main manifestations of poor prognosis were heart failure,arrhythmia,death and reoccurrence of myocardial infarction.The difference in the total incidence rate of poor prognosis had statistical significance between 2 groups(P<0.05).Conclusion Heart rehabilitation has a higher curative effect in AMI patients after PCI,which may be related to the improvement of ET,vWF and prognosis.

关 键 词：急性心肌梗死 心脏康复 内皮素 血管性血友病因子 预后 

分 类 号：R542.22[医药卫生—心血管疾病]