心脏康复运动治疗对急性心肌梗死经皮冠状动脉介入术病人心功能及健康相关体适能的影响  

Impact of cardiac rehabilitation exercise therapy on cardiac function and health-related physical fitness in patients with acute myocardial infarction after PCI

作　　者：谷世奎[1] 朱丹丹 刘虹秀 郝亚逢[1] 王献忠[1] GU Shikui;ZHU Dandan;LIU Hongxiu;HAO Yafeng;WANG Xianzhong(Department of Cardiology,Handan First Hospital,Handan,Hebei 056004,Chin;Department of Nephrology,Handan First Hospital,Handan,Hebei 056004,China)

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

出　　处：《安徽医药》2024年第9期1778-1782,共5页Anhui Medical and Pharmaceutical Journal

基　　金：邯郸市科学技术研究与发展计划项目(21422083070)。

摘　　要：目的观察心脏康复运动治疗对急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)治疗病人心功能及健康相关体适能的影响。方法选择2021年6月至2022年3月在邯郸市第一医院行PCI治疗的AMI病人96例,按随机数字表法分为两组,对照组(n=48)给予常规护理,研究组(n=48)在对照组基础上给予心脏康复运动治疗。比较两组的心功能、健康相关体适能、6 min步行距离、干预期间不良心血管事件(MACE)发生情况。结果干预后,两组的左室射血分数(LVEF)、6 min步行距离均大于干预前(P<0.05),左室舒张末期容积(LVEDV)小于干预前(P<0.05),且研究组的LVEF(57.79±5.86)%、6 min步行距离(386.22±48.49)m大于对照组[(53.14±6.42)%、(357.63±45.51)m](P<0.05),LVEDV小于对照组(P<0.05)。干预后,研究组的峰值摄氧量(VO_(2)max)、氧脉搏、摄氧量对应功率的递增斜率(△VO_(2)/△WR)、代谢当量、握力指数、30 s连续椅子站立试验(30-CS)均大于干预前(P<0.05),体脂肪、内脏脂肪面积(VFA)均小于干预前(P<0.05),且研究组的VO_(2)max(20.32±1.64)mL·min^(-1)·kg-1、氧脉搏(12.93±2.45)mL/次、△VO_(2)/△WR(10.14±1.63)mL·min^(-1)·W^(-1)、代谢当量6.12±0.73、握力指数(53.91±5.62)%、30-CS(19.21±6.39)次均大于对照组[(19.47±1.76)mL·min^(-1)·kg-1、(11.74±2.66)mL/次、(9.43±1.78)mL·min^(-1)·W^(-1)、5.73±0.77、(50.18±8.83)%、(16.43±6.04)次](P<0.05),体脂肪(25.88±5.23)%、VFA(94.14±27.32)cm^(2)均小于对照组[(28.52±7.04)%、(105.64±28.11)cm^(2)](P<0.05)。研究组的干预期间MACE总发生率低于对照组(P<0.05)。结论行PCI治疗的AMI病人接受心脏康复运动治疗,利于改善心功能,提高健康相关体适能,增大6 min步行距离,减少干预期间MACE发生。Objective To observe the impact of cardiac rehabilitation exercise therapy on cardiac function and health-related physical fitness in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 96 AMI patients who underwent PCI at Handan First Hospital from June 2021 to March 2022 were selected and divided into two groups according to the randomized numerical table method,with the control group(n=48)receiving conventional care and the study group(n=48)receiving cardiac rehabilitation exercise therapy on the basis of the control group.Cardiac function,health-related physical fitness,6-minute walking distance and major adverse cardiovascular events(MACEs)during the intervention period were compared between the two groups.Results After the intervention,the left ventricular ejection fraction(LVEF)and the 6 min walking distance were greater than those before the intervention(P<0.05),the left ventricular end-diastolic volume(LVEDV)was less than that before the intervention in both groups(P<0.05),the LVEF(57.79±5.86)%and the 6 min walking distance(386.22±48.49)m were greater than those in the control group(53.14±6.42)%and(357.63±45.51)m,respectively,and the LVEDV was less than that in the control group(P<0.05).After the intervention,the peak oxygen uptake(VO_(2)max),oxygen pulse rate,increasing slope of oxygen uptake corresponding to power(△VO_(2)/△WR),metabolic equivalent,grip strength index,and 30-s continuous chair stand test(30-CS)were greater than those before the intervention in the study group(P<0.05);body fat and visceral fat area(VFA)were smaller than those before the intervention(P<0.05);and the study group's VO_(2)max(20.32±1.64)mL·min^(-1)·kg-1,oxygen pulse(12.93±2.45)mL/time,△VO_(2)/△WR(10.14±1.63)mL·min^(-1)·W^(-1),metabolic equivalent 6.12±0.73,grip index(53.91±5.62)%,and 30-CS(19.21±6.39)time were greater than those of the control group[(19.47±1.76)mL·min^(-1)·kg-1,(11.74±2.66)mL/time,(9.43±1.78)mL·min^(-1)·W^(-1),5.73±1.78,

关 键 词：心脏康复 心肌梗死 经皮冠状动脉介入术 心功能 

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