心脏康复干预对经皮冠状动脉介入术后心肺功能、远期主要心血管不良事件的影响  

Effect of Cardiac Rehabilitation Intervention on Cardiopulmonary Function and Long-term MACEs after Percutaneous Coronary Intervention

作　　者：李玉丽 赵旭 赵艳 赵殿儒 李向华 左灿灿 LI Yuli;ZHAO Xu;ZHAO Yan;ZHAO Dianru;LI Xianghua;ZUO Cancan(First Department of Cardiology,Cangzhou People's Hospital,Cangzhou 061000,Hebei,China;Third Department of Cardiology,Cangzhou People's Hospital,Cangzhou O61000,Hebei,China;Department of Nursing,Cangzhou People's Hospital,Cangzhou 061000,Hebei,China;Department of Cardiology,Hai'an People's Hospital,Nantong 226600,Jiangsu,China)

机构地区：[1]沧州市人民医院心内一科,河北沧州061000 [2]沧州市人民医院心内三科,河北沧州061000 [3]沧州市人民医院护理部,河北沧州061000 [4]海安市人民医院心血管内科,江苏南通226600

出　　处：《中国分子心脏病学杂志》2024年第5期6357-6362,共6页Molecular Cardiology of China

基　　金：沧州市重点研发计划指导项目(213106018)。

摘　　要：目的观察心脏康复干预对经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后心肺功能、远期主要心血管不良事件(major adverse cardiovascular events,MACEs)的影响,并探讨其可能机制。方法选取2021年1月至2022年4月接受PCI治疗的152例冠状动脉性心脏病(coronary heart disease,CHD)患者为对象,采用随机数字表法分为两组。对照组给予常规内科治疗,观察组在对照组基础上联合心脏康复干预。分别于治疗前和治疗后3个月比较两组左心室射血分数(left ventricular ejection fraction,LVEF)、舒张前期二尖瓣血流速度与舒张前期二尖瓣环运动速度比(pre-diastolic mitral annulus motion ratio,E/e′)、六分钟步行试验(6 minutes walking test,6MWT)距离、心肺运动试验指标及血清miR-29b、肌钙蛋白I(troponin I,cTnI)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平差异,并比较两组MACEs发生率。结果两组治疗前LVEF、E/e′、6MWT比较,差异无统计学意义(P均>0.05)。治疗后3个月,两组LVEF、6MWT距离较治疗前升高,观察组较对照组更高(P均<0.05);两组E/e′较治疗前降低,观察组较对照组更低(P均<0.05)。两组治疗前血清miR-29b、cTnI、CK-MB、NT-proBNP比较,差异无统计学意义(P均>0.05)。治疗后3个月,两组血清miR-29b较治疗前升高,观察组较对照组更高(P均<0.05);两组血清cTnI、CK-MB、NT-proBNP较治疗前降低,观察组较对照组更低(P均<0.05)。两组治疗前心肺运动试验指标比较,差异无统计学意义(P均>0.05)。治疗后3个月,两组峰值耗氧量(peak oxygen demand,Peak VO_(2))、无氧阈氧耗量(anaerobic threshold oxygen consumption,VO_(2)AT)较治疗前升高,观察组较对照组更高(P均<0.05);两组二氧化碳通气当量斜率(carbon dioxide ventilation equivalent slope,VE/VCO_(2)slope)较治疗前降低,观察组较对照组更低(P均<0.05)。随访12个月内,�Objective To observe the effects of cardiac rehabilitation intervention on cardiopulmonary function and long-term major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI),and to explore its possible mechanism.Methods A total of 152 patients with coronary heart disease(CHD)who underwent PCI in our hospital from January 2021 to April 2022 were selected as research objects,and were divided into two groups by random number table method.The control group received conventional medical treatment,and the observation group was combined with cardiac rehabilitation intervention on the basis of the control group.Pre-intervention and 3 months post-intervention,left ventricular ejection fraction(LVEF),pre-diastolic mitral annulus motion ratio(E/e′),6-minute walking test(6MWT)distance,cardiopulmonary exercise test indexes and serum miR-29b,troponin I(cTnI),creatine kinase isoenzyme(CK-MB),n-terminus B-type brain natriuretic peptide prenatrium(NT-proBNP)were compared between the two groups.The difference of NT-proBNP level was analyzed,and the incidence of major cardiovascular adverse events(MACE)was calculated between the two groups.Results There were no significant differences in LVEF,E/e′and 6MWT between the two groups before treatment(allP>0.05).After treatment,LVEF and 6MWT in observation group and control group were higher than before treatment,and the observation group was higher than control group(allP<0.05).E/e′in the observation group and the control group was lower than before treatment,and the observation group was lower than the control group(allP<0.05).There was no significant difference in serum miR-29b,cTnI,CK-MB and NT-proBNP between the two groups before treatment(allP>0.05).After treatment,the serum miR-29b in observation group and control group was higher than before treatment,and the observation group was higher than control group(allP<0.05).Serum cTnI,CK-MB and NT-proBNP in the observation group and control group were lower than before treatment,and the observation group

关 键 词：心脏康复 冠状动脉性心脏病 经皮冠状动脉介入 运动耐力 心肺功能 

分 类 号：R541.4[医药卫生—心血管疾病]