单硝酸异山梨酯联合早期心脏康复对PCI后患者心功能及左心室重构的影响  

Effect of Isosorbide Mononitrate Combined with Early Cardiac Rehabilitation on Cardiac Function and Left Ventricular Remodeling in Patients after PCI

作　　者：唐萌[1] 吴尽[1] 李茉 张淼[1] 门苗 罗晶 路璐 韩雅婧 田迎春[1] 孙雅洁 TANG Meng;WU Jin;LI Mo;ZHANG Miao;MEN Miao;LUO Jing;LU Lu;HAN Yajing;TIAN Yingchun;SUN Yajie(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京市100029

出　　处：《实用心脑肺血管病杂志》2024年第7期106-109,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的 探讨单硝酸异山梨酯联合早期心脏康复对PCI后患者心功能及左心室重构的影响。方法 选取2022年1月—2023年4月首都医科大学附属北京安贞医院收治的PCI后患者133例为研究对象,采用随机数字表法将其分为对照组(n=44)、单硝酸异山梨酯组(n=45)及联合组(n=44)。对照组患者PCI后接受阿托伐他汀治疗联合常规康复;单硝酸异山梨酯组患者接受阿托伐他汀联合单硝酸异山梨酯治疗,在此基础上进行常规康复;联合组患者在单硝酸异山梨酯组基础上进行早期心脏康复,三组均干预4周。比较三组干预前后心功能指标、左心室重构指标、运动耐量指标。结果 干预4周后,单硝酸异山梨酯组、联合组N末端脑钠肽前体(NT-proBNP)、左心室短轴缩短率(LVFS)低于对照组,联合组NT-proBNP、LVFS低于单硝酸异山梨酯组(P<0.05)。干预4周后,单硝酸异山梨酯组、联合组左心室收缩期纵向峰值应变率低于对照组,左心室舒张早期纵向峰值应变率高于对照组(P<0.05);干预4周后,联合组左心室收缩期纵向峰值应变率低于单硝酸异山梨酯组,左心室舒张早期纵向峰值应变率高于单硝酸异山梨酯组(P<0.05)。干预4周后,单硝酸异山梨酯组、联合组6分钟步行距离(6MWD)、运动终点时间长于对照组,运动期间最大心率慢于对照组(P<0.05);干预4周后,联合组6MWD、运动终点时间长于单硝酸异山梨酯组,运动期间最大心率慢于单硝酸异山梨酯组(P<0.05)。结论 单硝酸异山梨酯联合早期心脏运动康复能有效改善PCI后患者心功能,减轻左心室重构,增加患者运动耐量。Objective To investigate the effect of isosorbide mononitrate combined with early cardiac rehabilitation on cardiac function and left ventricular remodeling in patients after PCI.Methods A total of 133 patients after PCI admitted to Beijing Anzhen Hospital,Capital Medical University from January 2022 to April 2023 were selected as the research objects,and they were divided into control group(n=44),isosorbide mononitrate group(n=45)and combined group(n=44)by random number table method.Patients in the control group received atorvastatin treatment combined with routine rehabilitation after PCI,patients in the isosorbide mononitrate group were treated with atorvastatin combined with isosorbide mononitrate,and routine rehabilitation was carried out on this basis,patients in the combined group were given early cardiac rehabilitation on the basis of isosorbide mononitrate group,and the three groups were intervened for 4 weeks.The cardiac function indexes,left ventricular remodeling indexes and exercise tolerance indexes before and after intervention were compared in the three groups.Results After 4 weeks of intervention,N-terminal pro-brain natriuretic peptide(NT-proBNP)and left ventricular fractional shortening(LVFS)in the isosorbide mononitrate group and the combined group were lower than those in the control group,and NT-proBNP and LVFS in the combined group were lower than those in the isosorbide mononitrate group(P<0.05).After 4 weeks of intervention,the left ventricular systolic longitudinal peak strain rate in the isosorbide mononitrate group and the combined group was lower than that in the control group,and the left ventricular early diastolic longitudinal peak strain rate was higher than that in the control group(P<0.05).After 4 weeks of intervention,the left ventricular systolic longitudinal peak strain rate in the combined group was lower than that in the isosorbide mononitrate group,and the left ventricular early diastolic longitudinal peak strain rate was higher than that in the isosorbide mononitrate grou

关 键 词：心脏康复 单硝酸异山梨酯 经皮冠状动脉介入治疗 心功能 心室重构 

分 类 号：R541[医药卫生—心血管疾病]