不同强度康复运动对急性心肌梗死后心功能不全患者的影响  

The effect of different intensities of rehabilitation exercise on patients with cardiac dysfunction after acute myocardial infarction

作　　者：袁方正 王强[1] 肖秋金 许梦阅 王洪如 YUAN Fang-Zheng;WANG Qiang;XIAO Qiu-Jin(Department of Cardiology,908 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Nanchang 330001,Jiangxi,China)

机构地区：[1]中国人民解放军联勤保障部队第908医院心内科,江西南昌330001 [2]中国人民解放军联勤保障部队第908医院超声诊断科,江西南昌330001

出　　处：《吉林医学》2024年第11期2624-2628,共5页Jilin Medical Journal

基　　金：江西省卫生健康委科技计划项目[项目编号:202211374]。

摘　　要：目的:比较不同强度的康复运动对急性心肌梗死后心功能不全患者获益差异,为指导该类患者行康复运动提供临床依据。方法:选取中国人民解放军联勤保障部队第908医院2021年6月~2023年2月收治的急性心肌梗死急诊经皮冠状动脉介入治疗(PCI)术后合并心功能不全患者为研究对象,随机分为静息组(REST)、低强度训练组(LICT)、中等强度训练组(MICT)和间歇性高强度训练组(HIIT),予不同强度康复运动24周,3次/周,比较左心室射血分数(LVEF)、舒张末期左心室容积(LVEDv)、E峰值、左心房前后径(LA-ap)、N末端脑钠肽前体(NT-proBNP)及6 min步行试验(6MWT),并随访重大不良心血管事件发生情况。结果:75例患者纳入研究,其中REST组18例、LICT组19例、MICT组17例、HIIT组21例,性别、年龄等临床一般资料及LVEDv、NT-proBNP及6 MWT等心功能指标四组之间差异无统计学意义(P>0.05)。康复训练24周后,与REST组比较,行MICT、HIIT的康复运动组LVEDv、LA-ap、NT-proBNP均显著降低,差异有统计学意义(P<0.05),LVEF和E峰值、6 MWT均显著提升,差异有统计学意义(P<0.05);与行MICT组比较,行HIIT组LVEDv进一步显著降低,差异有统计学意义(P<0.05),LVEF、6 MWT进一步显著升高,差异有统计学意义(P<0.05)。与REST组比较,行LICT组6 MWT升高,差异有统计学意义(P<0.05)。不良心血管事件发生情况,REST组7例、LICT组6例、MICT组2例、HIIT组1例。结论:行MICT、HIIT强度的康复训练方式均能改善急性心肌梗死后合并心功能不全患者的心功能,其中行HIIT训练方式尤为明显,该类患者以间歇性高强度康复训练为宜。Objective To compare the benefits of different intensities of rehabilitation exercise in patients with cardiac insufficiency after acute myocardial infarction,to provide a clinical basis for guiding rehabilitation exercise for these patients.Method The patients with cardiac dysfunction after emergency operation of acute myocardial infarction admitted to the 908 Hospital of the Joint Support Force of the Chinese People's Liberation Army from June 2021 to February 2023 were selected as the research objects,they were randomly divided into the resting(REST)group,low-intensity training(LICT)group,moderate-intensity training(MICT)group and intermittent high-intensity training(HIIT)group,who were given with rehabilitation exercises at different intensities for 24 weeks,three times a week.LVEF,LVEDv,E peak,LA-ap,NT-proBNP and 6-minute walking distance was compared,and the follow-up on the occurrence of major adverse cardiovascular events was performed.Results A total of 75 patients were included in the study,including 18 patients in the REST group,19 patients in the LICT group,17 patients in the MICT group,and 21 patients in the HIIT group.There was no significant difference between the four groups in terms of general clinical data such as gender and age,as well as cardiac function indexes,including LVEDv,NT-proBNP and 6-minute walking distance(P>0.05).After 24 weeks of rehabilitation training,compared with the REST group,LVEDv,LA-ap and NT-proBNP was significantly reduced in the rehabilitation exercise group-MICT group and HIIT group(P<0.05);the LVEF,E peaks and 6-minute walking distance was significantly increased(P<0.05);compared with HIIT group and MICT group,the LVEDv was further significantly decreased(P<0.05),LVEF and 6-minute walking distance was further significantly increased(P<0.05).Compared with the REST group,the 6-minute walking distance increased in the LICT group.Adverse cardiovascular events occurred in 7 cases in the REST group,6 cases in the LICT group,2 cases in the MICT group,and 1 case in the HIIT g

关 键 词：急性心肌梗死 心脏康复运动 强度训练 心功能 

分 类 号：R541[医药卫生—心血管疾病]