心脏康复治疗对急性心肌梗死PCI术后心肌微循环、运动能力及生活质量的影响  

Influence of heart rehabilitation on myocardial microcirculation,exercise ability and quality of lifein patients with acute myocardial infarctionafter 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》2024年第4期429-432,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(AMI)患者经皮冠状动脉介入治疗(PCI)术后心肌微循环、运动能力及生活质量的影响。方法选择2021年9月至2022年6月于邯郸市第一医院接受治疗的AMI手术治疗患者120例,采用随机数字表法分为试验组(n=63)和对照组(n=57)。对照组给予术后常规治疗,试验组在对照组基础上联合心脏康复治疗。比较两组患者的临床疗效、心肌微循环灌注情况、左室射血分数(LVEF)、6 min步行试验(6MWT)、生理健康总评分(PCS)、心理健康总评分(MCS)及心脏并发症发生情况。结果试验组患者治疗总有效率远高于对照组(85.71%vs.70.18%),组间差异具有统计学意义(P<0.05)。两组患者治疗前心肌微循环灌注水平相比,差异无统计学意义(P>0.05)。治疗后两组患者心肌微循环灌注升高,差异有统计学意义(P<0.05),且试验组升高水平较对照组更显著(P<0.05)。治疗后两组患者LVEF、6MWT升高,差异有统计学意义(P<0.05),且试验组升高水平较于对照组更显著(P<0.05)。治疗后两组患者MCS、PCS评分升高,差异有统计学意义(P<0.05),其中试验组升高水平较对照组更显著(P<0.05)。治疗期间的心脏不良反应主要包括:心绞痛、心力衰竭和心律失常,两组不良反应发生率比较,有统计学差异(P<0.05)。结论在AMI患者PCI术后,心脏康复治疗具有较好疗效,可有效改善患者心肌微循环、运动能力及生活质量水平。Objective To discuss the influence of heart rehabilitation on myocardial microcirculation,exercise ability and quality of life(QOL)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 Jun.2022,and all patients were divided into test group(each n=63)and control group(n=57)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,myocardial microcirculation perfusion,left ventricular ejection fraction(LVEF),6-minute walk test(6MWT),total physical content score(PCS),total mental content score(MCS)and cardiac complications were compared between 2 groups.Results The total effective rate was significantly higher in test group than that in control group(85.71%vs.70.18%,P<0.05).The difference in level of myocardial microcirculation perfusion had no statistical significance between 2 groups before treatment(P>0.05).After treatment,level of myocardial microcirculation perfusion increased in 2 groups(P<0.05),which was more significant in test group(P<0.05).The indexes of LVEF and 6MWTincreased in 2 groups(P<0.05),which was more significant in test group(P<0.05).After treatment,MCS and PCSincreased in 2 groups(P<0.05),which was more significant in test group(P<0.05).During treatment,the main adverse cardiac reactions included angina pectoris,heart failure and arrhythmia,and incidence of adversereactions had statistical difference between 2 groups(P<0.05).Conclusion The heart rehabilitation has a higher curative effect in AMI patients after PCI,which may effectively improve levels of myocardial microcirculation,exercise ability and QOL.

关 键 词：急性心肌梗死 心肌微循环 心脏康复 运动能力 生活质量 

分 类 号：R542.22[医药卫生—心血管疾病]