摘要
目的探讨心肺运动测试指导下的心脏康复训练对急性心肌梗死患者经皮冠状动脉介入治疗(PCI)术后的心肺储备功能和生活质量的影响。方法选择2019年1月至2020年12月于渭南市中心医院心血管内科接受PCI术的100例急性心肌梗死患者为研究对象,根据随机数表法将患者分为观察组和对照组各50例。对照组患者采用常规心脏康复训练,观察组患者采用心肺运动测试指导下的心脏康复训练,均持续干预3个月。比较两组患者干预前、干预3个月后的峰值耗氧量(peak VO_(2))、无氧阈氧耗量(VO_(2)AT)、二氧化通气当量斜率(VE/VCO_(2)slope)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、中国心血管病人生活质量评定问卷(CQQC)评分的变化及随访1年的再住院率和病死率。结果干预后,观察组患者的peak VO_(2)、VO_(2)AT分别为(25.72±2.06)mL/(min·kg)、(14.72±1.85)mL/(min·kg),明显高于对照组的(23.15±1.98)m L/(min·kg)、(12.13±1.70)mL/(min·kg),VE/VCO_(2)slope为25.02±2.28,明显低于对照组的28.33±2.47,差异均有统计学意义(P<0.05);干预后,观察组患者的LVEF为(57.02±4.26)%,明显高于对照组的(53.58±4.30)%,LVEDD、LVESD分别为(44.09±4.62)mm、(32.12±3.87)mm,明显低于对照组的(48.13±4.27)mm、(36.57±3.25)mm,差异均有统计学意义(P<0.05);干预后,观察组患者的CQQC评分为(78.83±6.09)分,明显高于对照组的(72.15±5.26)分,差异有统计学意义(P<0.05);随访1年中,观察组失访6例,对照组失访5例,观察组患者的再住院率为4.55%,明显低于对照组的17.78%,差异有统计学意义(P<0.05),而观察组和对照组患者的病死率分别为2.27%、4.44%,差异无统计学意义(P>0.05)。结论心肺运动测试指导下的心脏康复训练应用于急性心肌梗死患者PCI术后,有助于改善患者的心肺储备功能和生活质量,降低再住院率。
Objective To study the effect of cardiopulmonary exercise test-guided cardiac rehabilitation training on cardiopulmonary reserve function and quality of life in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 100 patients with acute myocardial infarction who underwent PCI in Department of Cardiovascular Medicine,Weinan Central Hospital from January 2019 to December 2020 were selected and divided into an observation group and a control group according to the random number table method,with 50 cases in each group.Patients in the control group received conventional cardiac rehabilitation training,while patients in the observation group received cardiopulmonary exercise test-guided cardiac rehabilitation training,both for 3 months.The peak oxygen consumption(peak VO2),anaerobic threshold oxygen consumption(VO_(2)AT),oxidative ventilation equivalent slope(VE/VCO_(2)slope),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),Chinese Cardiovascular Patients Quality of Life Questionnaire(CQQC)score at before intervention and 3 months after intervention,and readmission rate,mortality rate during 1-year follow-up were compared between the two groups.Results After intervention,peak VO_(2) and VO2AT in the observation group were(25.72±2.06)mL/(min·kg)and(14.72±1.85)mL/(min·kg),which were significantly higher than(23.15±1.98)mL/(min·kg)and(12.13±1.70)mL/(min·kg)in the control group,and VE/VCO_(2)slope was 25.02±2.28,which was significantly lower than(28.33±2.47)in the control group,with statistically significant differences(P<0.05).After intervention,the LVEF in the observation group was(57.02±4.26)%,which was significantly higher than(53.58±4.30)%in the control group,and the LVEDD and LVESD were(44.09±4.62)mm and(32.12±3.87)mm,which were significantly lower than(48.13±4.27)mm and(36.57±3.25)mm in the control group,with statistically significant differences(P<0.05).After intervention,the CQQC score in the observation group was 78.83±6.09,which was significantly higher than 72.15±5.26 in the control group(P<0.05).During the 1-year follow-up,6 cases in the observation group and 5 cases in the control group were lost to follow-up;the readmission rate in the observation group was 4.55%,which was significantly lower than 17.78%in the control group(P<0.05).The mortality rates in the observation group and the control group were 2.27%and 4.44%,and the difference was not statistically significant(P>0.05).Conclusion The application of cardiac rehabilitation training guided by cardiopulmonary exercise test in patients with acute myocardial infarction after PCI can help improve their cardiopulmonary reserve function and quality of life,as well as reduce the rate of rehospitalization.
作者
权党军
赵俊龙
王晓玲
QUAN Dang-jun;ZHAO Jun-long;WANG Xiao-ling(Department of Cardiovascular Medicine Weinan Central Hospital,Weinan 714000,Shaanxi,CHINA;Department of Rehabilitation Medicine,Weinan Central Hospital,Weinan 714000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第20期2929-2933,共5页
Hainan Medical Journal
关键词
急性心肌梗死
经皮冠状动脉介入治疗术
心肺运动测试
心脏康复训练
心肺储备功能
生活质量
Acute myocardial infarction
Percutaneous coronary intervention
Cardiopulmonary exercise test
Cardiac rehabilitation training
Cardiopulmonary reserve function
Quality of life
作者简介
第一作者:权党军(1981-),男,主治医师,主要从事冠心病、心力衰竭等疾病的诊治工作;通讯作者:王晓玲(1983-),女,主治医师,主要从事针灸康复研究工作,E-mail:quandangjun@163.com。
