【摘要】 目的探讨中西医结合Ⅰ期心脏康复在急性心肌梗死急诊经皮冠状动脉介入治疗(PCI)后病人中的应用效果。方法选取2019年7月—2020年2月我院行急诊PCI的ST段抬高型心肌梗死(STEMI)病人60例,随机分为康复组与对照组,每组30例。两组均行急诊PCI和临床常规治疗,康复组在此治疗基础上实施运动康复和睡眠、心理干预程序。比较两组入院24 h内、术后1周、术后3个月血清N末端脑钠肽前体(NT-proBNP)浓度、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)、匹兹堡睡眠指数量表及汉密尔顿焦虑量表积分;并比较两组术后1周、术后3个月主要心脏不良事件(MACE)发生率。结果术后1周、3个月,两组NT-proBNP浓度及LVEF、LVEDD、LVESD均较入院24 h内明显改善,且康复组改善情况明显优于同期对照组,差异均有统计学意义(P<0.05);康复组术后1周、术后3个月匹兹堡睡眠指数量表、汉密尔顿焦虑量表积分均低于同期对照组(P<0.05);术后3个月康复组MACE发生率低于对照组,差异有统计学意义(P<0.05)。结论对急性心肌梗死行急诊PCI术后病人进行早期中西医结合心脏康复可获得较为理想的效果,可明显改善病人心脏功能、睡眠、心理状态及预后。更多还原

【Abstract】 Objective To investigate the effect of stage Ⅰ cardiac rehabilitation therapy on patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods Sixty patients with ST elevation myocardial infarction(STEMI) receiving emergency PCI in Liuzhou Traditional Chinese Medical Hospital from July 2019 to February 2020 were randomized divided into two groups:control group and rehabilitation group,with 30 cases in each group.All patients were administered emergency PCI and conventional treatment.The patients in rehabilitation group added physical rehabilitation and sleep,psychological intervention procedures.The concentrations of N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and integration of Pittsburgh Sleep Quality Index(PSQI) and Hamilton Anxiety Scale were compared between two groups within 24 hours of admission and at one week after PCI,and three month after PCI.The rate of major adverse cardiac events(MACEs) was compared between two groups at one week and three month after PCI.Results After PCI,the concentrations of NT-proBNP,LVEF,LVEDD,and LVESD of two group improved than admission,and the indexes in rehabilitation group were better than those in control group(P<0.05).At one week and three month after PCI,the integration of PSQI and Hamilton anxiety scale of rehabilitation group were significantly lower than those in control group(P<0.05).At three month after PCI,the occurrence of MACEs in rehabilitation group was lower than that in control group(P<0.05).Conclusion Cardiac rehabilitation can improve heart function,sleep and psychological station,and prognosis in the treatment of patients with acute myocardial infarction after PCI.更多还原