首页|心脏康复治疗对急性心肌梗死PCI术后患者的临床效果及炎性因子的影响

心脏康复治疗对急性心肌梗死PCI术后患者的临床效果及炎性因子的影响

Clinical effect of cardiac rehabilitation on patients with acute myocardial infarction after PCI and its effect on inflammatory factors

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目的:研究急性心肌梗死(AMI)经皮冠状动脉介入(PCI)术后患者应用心脏康复治疗的效果及对炎性因子的影响.方法:选择中国地质大学(武汉)医院2020年6月~2021年8月期间收治的AMI行PCI术后患者94例,随机分为对照组(采用常规治疗)和研究组(在常规治疗基础上采取个体化的心脏康复治疗),每组47例.比较两组患者治疗前、3个月后的心肺运动指标、血脂指标、炎症因子及心功能指标的变化.结果:与对照组比较,研究组治疗后的无氧阈[(15.46±3.07)ml·min-1·kg-1 比(19.37±3.27)ml·min-1·kg-1]、最大摄氧量[(21.26±4.05)ml·min-1·kg-1 比(25.31±4.10)ml·min-1·kg-1]、左室射血分数(LVEF)[(52.20±5.75)%比(57.91±5.17)%]、6min 步行距离(6MWD)[(430.58±43.87)m 比(481.52±44.57)m]和高密度脂蛋白胆固醇(HDL-C)[(1.30±0.32)mmol/L 比(1.49±0.35)mmol/L]、白细胞介素(IL)-10[(5.45±0.55)pg/ml 比(6.19±0.59)pg/ml]水平均显著升高(P均<0.01),甘油三酯(TG)[(1.88±0.65)mmol/L比(1.54±0.63)mmol/L]、总胆固醇(TC)[(3.49±0.54)mmol/L 比(3.13±0.47)mmol/L]、低密度脂蛋白胆固醇(LDL-C)[(2.12±0.59)mmol/L 比(1.57±0.52)mmol/L]、肿瘤坏死因子-α(TNF-α)[(128.34±14.5)pg/ml 比(99.28±8.51)pg/ml]、瘦素(LEP)[(623.49±61.27)pg/ml 比(483.57±47.61)pg/ml]、N 端 B型利钠肽前体(NT-proBNP)[(396.59±18.12)pg/ml 比(302.96±17.56)pg/ml]水平均显著降低(P<0.05或<0.01).结论:心脏康复治疗能显著改善AMI患者PCI术后血脂水平,提升心功能及运动耐力,有效降低炎性因子水平,是AMI患者PCI术后二级预防的重要组成部分.
Objective:To study the therapeutic effect of cardiac rehabilitation in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)and its effect on inflammatory factors.Methods:A total of 94 AMI patients after PCI admitted in Hospital of China University of Geosciences(Wuhan)between June 2020 and August 2021 were selected and randomly divided into control group(n=47,routine therapy)and study group(n=47,individualized cardiac rehabilitation therapy based on routine therapy).Cardiopulmonary exercise indexes,blood lipid indexes,inflamma-tory factors and cardiac function indexes were compared between two groups before and 3 months after treatment.Results:Compared with control group after treatment,participants in study group had significant higher anaerobic threshold[(15.46±3.07)ml·min-1·kg-1 vs.(19.37±3.27)ml·min 1·kg-1],maximal oxygen uptake[(21.26±4.05)ml·min-1·kg-1 vs.(25.31±4.10)ml·min-1·kg-1],left ventricular ejection fraction(LVEF)[(52.20±5.75)%vs.(57.91±5.17)%],6min walking distance(6MWD)[(430.58±43.87)m vs.(481.52±44.57)m]and levels of high density lipoprotein cholesterol(HDL-C)[(1.30±0.32)mmol/L vs.(1.49±0.35)mmol/L]and interleukin(IL)-10[(5.45±0.55)pg/ml vs.(6.19±0.59)pg/ml](P<0.01 all),and significant lower levels of triglyceride(TG)[(1.88±0.65)mmol/L vs.(1.54±0.63)mmol/L],total cholesterol(TC)[(3.49±0.54)mmol/L vs.(3.13±0.47)mmol/L],low density lipoprotein cholesterol(LDL-C)[(2.12±0.59)mmol/L vs.(1.57±0.52)mmol/L],tumor necrosis factor-α(TNF-α)[(128.34±14.5)pg/ml vs.(99.28±8.51)pg/ml],leptin(LEP)[(623.49±61.27)pg/ml vs.(483.57±47.61)pg/ml]and N terminal pro B-type natriuretic peptide(NT-proBNP)[(396.59±18.12)pg/ml vs.(302.96±17.56)pg/ml](P<0.05 or<0.01).Conclusion:Cardiac rehabilitation therapy can significantly im-prove the blood lipid levels,cardiac function and exercise endurance,and effectively reduce the levels of inflammatory fac-tors in AMI patients after PCI,which is an important component of secondary prevention in these patients.

Myocardial infarctionAngioplasty,balloon,coronaryRehabilitation

孙雪平、魏从兵、刘小娣、何家振、夏贤龙

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中国地质大学(武汉)医院内科,湖北武汉 430074

武汉市黄陂区中医医院心血管病科

心肌梗死 血管成形术,气囊,冠状动脉 康复

2024

心血管康复医学杂志
福建省康复医学会 中国康复医学会

心血管康复医学杂志

CSTPCD
影响因子:1.157
ISSN:1008-0074
年,卷(期):2024.33(5)