新型心脏康复模式训练对老年急性心肌梗死病人PCI术后心脏收缩功能的影响

doi:10.3969/j.issn.1003-9198.2021.12.007

摘要/Abstract

摘要： 目的探讨新型心脏康复模式对老年急性心肌梗死(AMI)病人经皮冠状动脉介入术(PCI)后心脏收缩功能的影响。方法选取我院2017年5月至2019年5月收治的行PCI的老年AMI病人160例,按随机数表法分成观察组与对照组各80例。对照组行常规康复训练,观察组行新型心脏康复训练,分别在干预前、干预后3个月检测2组心功能的变化,包括左心房内径(LAD)、LVEF、左室舒张末内径(LVEDD)、左室收缩末容积(LVESV)、室壁运动积分指数(WMSI)、左室舒张末容积(LVEDV);采用西雅图心绞痛量表(SAQ)在干预前后评估2组心绞痛症状的改善效果,并记录2组不良事件发生情况。结果 2组干预后LVEF高于干预前,LVESV、WMSI、LVEDV低于干预前,且观察组LVEF显著高于对照组,WMSI、LVEDV显著低于对照组(P＜0.05或P＜0.01)。干预后SAQ量表结果显示,2组心绞痛发作频率、心绞痛稳定程度、治疗满意度、躯体活动受限情况、疾病认知情况评分均高于干预前,且观察组较对照组显著增高(P＜0.05或P＜0.01)。2组心力衰竭、休克、心律失常发生率及死亡率比较,差异均无统计学意义(P＞0.05)。结论新型心脏康复模式能促进老年AMI病人心功能改善,并进一步缓解心绞痛症状,值得推广应用。

关键词: 急性心肌梗死, 经皮冠状动脉介入术, 新型心脏康复模式, 心脏收缩功能

Abstract: Objective To explore the effect of a new cardiac rehabilitation model on cardiac systolic function in the elderly patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods A prospective research was carried out, and 160 elderly patients with AMI receiving PCI admitted to our hospital from May 2017 to May 2019 were enrolled.The patients were divided into observation group and control group by random number table, with 80 cases in each group.The control group received routine rehabilitation training, while the observation group received new cardiac rehabilitation training. The changes of cardiac function in the two groups were measured before intervention and 3 months after intervention, including left atrial diameter (LAD), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic volume (LVESV), wall motion score index (WMSI), and left ventricular end-diastolic volume (LVEDV).The symptoms of angina pectoris was evaluated by Seattle Angina Questionnaire (SAQ) before and after intervention, and the adverse events were recorded in both groups. Results After intervention, the level of LVEF of the two groups was higher and the levels of LVESV, WMSI and LVEDV were lower than those before intervention(P<0.05), especially in the observation group (P<0.05).After intervention, the frequency of angina attack, the degree of angina stability, the satisfaction of treatment, the limitation of physical activity and the score of disease recognition in the two groups were higher than those before intervention, especially in the observation group (P<0.05 or P＜0.01).There was no difference in the incidence rate of heart failure, shock, arrhythmia and mortality between the two groups (P>0.05). Conclusions The new cardiac rehabilitation model can promote the improvement of cardiac function in the elderly patients with AMI and further alleviate the symptoms of angina pectoris, which is worthy of popularization and application.

Key words: acute myocardial infarction, percutaneous coronary intervention, new heart rehabilitation model, cardiac systolic function

中图分类号:

赵冬婧, 汤玮, 曹树军, 胡硕强, 杨娜, 佟子川. 新型心脏康复模式训练对老年急性心肌梗死病人PCI术后心脏收缩功能的影响[J]. 实用老年医学, 2021, 35(12): 1236-1240.

ZHAO Dong-jing, TANG Wei, CAO Shu-jun, HU Shuo-qiang, YANG Na, TONG Zi-chuan. Effect of new cardiac rehabilitation training on cardiac systolic function in the elderly patients with acute myocardial infarction after percutaneous coronary intervention[J]. Practical Geriatrics, 2021, 35(12): 1236-1240.

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