【摘要】 目的探讨中西医结合Ⅰ期心脏康复对行急诊经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)患者左心功能的影响。方法选取2018年5月—2019年5月在柳州市中医医院行急诊PCI的80例STEMI患者作为研究对象,采用随机数字表法将患者分为治疗组和对照组各40例,2组患者术后均行常规药物治疗,治疗组则在常规药物治疗基础上给予中西医结合Ⅰ期康复干预1周。比较2组患者入院24 h内、术后1周、术后3个月的血清N末端脑钠肽前体(NT-proBNP)、血管紧张素Ⅱ(AngⅡ)水平及左室射血分数(LVEF)、左室短轴缩短率(FS)、每搏量(SV)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVEDs),术后1周、术后3个月心功能分级情况、6 min步行试验距离及心血管不良事件发生情况。结果 2组患者术后1周和术后3个月的NT-proBNP、AngⅡ水平及LVEF、FS、SV、LVEDd、LVEDs均较入院24 h内明显改善,且治疗组术后1周和术后3个月的上述指标均明显优于同期对照组,差异均有统计学意义(P均<0.05)。术后3个月2组患者心功能分级积分均较术后1周降低,6 min步行试验距离均较术后1周增加,且治疗组以上指标均优于同期对照组,差异均有统计学意义(P均<0.05)。术后1周2组心血管不良事件发生情况比较差异无统计学意义(P>0.05),术后3个月治疗组心血管不良事件发生率明显低于对照组(P<0.05)。结论中西医结合Ⅰ期心脏康复能有效改善行急诊PCI术的STEMI患者左心功能,从而改善其生活质量及近期预后,且安全。更多还原

【Abstract】 Objective It is to investigate the effect of phase I cardiac rehabilitation of integrated traditional Chinese and western medicine on left ventricular function in patients with acute ST-segment elevation myocardial infarction(STEMI) after emergency percutaneous coronary intervention(PCI). Methods Eighty patients with acute STEMI who underwent emergency PCI in Liuzhou Hospital of Traditional Chinese Medicine from May 2018 to May 2019 were selected as the research objects. They were divided into a treatment group and a control group by a random number table method, with 40 cases in each group. All the patients in both groups were treated with conventional medicine, and the treatment group was given a phase I rehabilitation intervention of integrated traditional Chinese and western medicine on the basis of conventional drug treatment for 1 week. The levels of serum N-terminal pro-brain natriuretic peptide(NT-proBNP), angiotensin Ⅱ(Ang Ⅱ) and the left ventricular ejection fraction( LVEF), left ventricular short axis shortening rate(FS), stroke volume(SV), left ventricular end diastolic diameter(LVEDd), left ventricular end systolic diameter(LVEDs) within 24 h of admission, in 1 week and 3 months after surgery, cardiac function classification and 6 min walk test distance in 1 week and 3 months after surgery and occurrence of adverse cardiovascular events in 1 week and 3 months after surgery were compared between the two groups. Results The levels of NT-proBNP, AngⅡ, LVEF, FS, SV, LVEDd, and LVEDs of the two groups were significantly improved at 1 week and 3 months after the operation compared with those within 24 h after admission, the above indicators in 1 week and 3 months after surgery in the treatment group were significantly better than those in the control group during the same period, and the differences were statistically significant(all P<0.05). At 3 months after operation, the cardiac function classification scores were lower and the distance of the 6 min walk test was longer compared with the first week after operation in the two groups(all P<0.05), the above indicators in the treatment group were better than those in the control group during the same period, and the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse cardiovascular events between the two groups at 1 week after surgery(P>0.05), and the incidence of adverse cardiovascular events in the treatment group was significantly lower than that in the control group at 3 months after surgery(P<0.05). Conclusion Phase I cardiac rehabilitation of integrated traditional Chinese and western medicine can effectively improve the left ventricular function of STEMI patients after emergency PCI, thereby improving their quality of life and short-term prognosis with good safety.更多还原