【摘要】 目的检测急性心肌梗死(AMI)患者进行早期指导性康复运动和无康复运动者分别在发病第3天及3个月时血清N末端B型钠尿肽前体(NT-proBNP)的水平、左室射血分数(LVEF)和左室舒张末期直径(LVDd)的变化,探讨AMI无严重并发症患者早期康复运动的血清NT-proBNP水平、心脏功能情况。方法选择54例AMI无严重并发症患者,运动组29人(运动+药物治疗),非运动组25人(仅药物治疗)。在AMI第3天做超声心动图检查及检测患者血清NT-proBNP水平,于AMI后3个月时重复上述检查。结果(1)运动组的患者心梗第3天及3个月时NT-proBNP水平从1076.00(666.50-1723.50)ng/L显著下降至211.00(141.75-374.00)ng/L(P<0.05),非运动组的患者血清NT-proB-NP水平从573.00(231.00-1059.50)ng/L降至462.10(218.30-1042.00)ng/L,无显著变化。3个月时两组间有显著性差异(P<0.01)。(2)运动组患者心梗的第3天及3个月时LVDd(50.63±4.89)mm增加到(50.78±4.10)mm没有显著变化,但非运动组的患者从(50.31±4.27)mm增加到(51.85±4.37)mm,LVDd呈显著增加。3个月时两组间LVDd比较有显著性差异(P<0.01)。(3)运动组患者心梗第3天及3个月时的LVEF从(55±9)%升高到(60±8)%,LVEF呈显著升高(P<0.05),非运动组的患者(53±9)%减少到(52±8)%,无显著性变化。3个月时两组间LVEF值有显著性差异(P<0.05)。结论AMI无严重并发症患者早期进行指导性康复运动是安全可行的,可以降低患者血清NT-proBNP水平,增加左室射血分数,可能降低左室舒张末期直径。更多还原

【Abstract】 Objective To get an insight into the serum N-terminal brain natriuretic peptide(NT-proBNP) levels,cardiac functions and left ventricular reconstruction of patients with acute myocardial infarction(AMI) with no severe complications who perform early rehabilitation exercises.Methods 54 cases of AMI patients with no severe complications were divided into 2 groups,with 29 in exercises group(exercises plus medication)and 25 in control group(medication only).Electrochemiluminescence was adopted to detect the NT-proBNP level at the 3rd day following AMI,with echocardiography performed to assess the heart structurally and functionally.Both tests were repeated after 3rd month to evaluate the changes dynamically.Results Results(1)It was found that in the exercises group,the level of NT-proBNP decreased significantly from 1076.00(666.50-1723.50) ng/L at the 3rd day to 211.00(141.75-374.00) ng/L 3rd month after onset(P<0.05),whereas it decreased from 573.00(231.00-1059.50) ng/L to 462.10(218.30-1042.00) ng/L in the control group,with no significant changes.At the end of the 3rd month,significant difference was seen between the two groups(P<0.01).(2)The left ventricular end-diastolic diameter(LVDd) of patients in exercises group increased from(50.63±4.89)mm of the 3rd day to(50.78±4.10)mm 3rd month after AMI onset,with no obvious changes,but significant augment from(50.31±4.27)mm to(51.85±4.37)mm was observed in the control group.There was significant difference in LVDd between both groups(P<0.01) 3rd month later.(3)In the exercises group,LVEF increased significantly from(55±9)% to(60±8)%(P<0.05),while in the control group there was no significant change in left ventricular emission blood fraction(LVEF),which reduced from(53±9)% to(52±8)%.After 3rd month,significant difference was observed in LVEF between the two groups(P<0.05).Conclusion Rehabilitation exercises of AMI patients with no severe complications in the early stages of the disease contribute to reducing the level of serum NT-proBNP,increasing LVEF and possibly decreasing left ventricular reconstruction at the same time with recorded safety and feasibility.更多还原