2021 年第 3 期 第 16 卷

心肺康复运动对老年急性心肌梗死患者经皮冠状动脉介入术后心肺功能及心脏舒张功能的影响

Effects of cardiopulmonary rehabilitation exercise on cardiopulmonary function and cardiac diastolic function in senile patients with acute myocardial infarction after percutaneous coronary intervention

作者：汪蕾蔡濛邓晓惠薛嫱

英文作者：Wang Lei Cai Meng Deng Xiaohui Xue Qiang

单位：北京积水潭医院干部科100035

英文单位：Department of Cadre Beijing Jishuitan Hospital Beijing 100035 China

关键词：急性心肌梗死；经皮冠状动脉介入；心肺康复运动；心肺功能；心脏舒张功能；心血管不良事件

英文关键词：Acutemyocardialinfarction;Percutaneouscoronaryintervention;Cardiopulmonaryrehabilitationexercise;Cardiopulmonaryfunction;Cardiacdiastolicfunction;Cardiovascularadverseevents

• 摘要：

• 目的探讨心肺康复运动对老年急性心肌梗死患者经皮冠状动脉介入（PCI）术后心肺功能及心脏舒张功能的影响。方法 选取2017年9月至2019年8月北京积水潭医院收治的87例老年急性心肌梗死患者为研究对象，依据盲抽法分为对照组（46例）与观察组（41例）。2组患者均经PCI治疗，对照组术后予常规康复治疗方案，观察组于对照组基础上予新型间歇心肺康复运动，2组均治疗12周。比较治疗前后2组心肺功能指标、心脏超声指标及治疗期间心血管不良事件发生率。结果 康复运动治疗后，2组最大摄氧量、最大每搏摄氧量、最大代谢当量均高于治疗前，且观察组均高于对照组［（24.6±3.5）ml/（min·kg）比（21.3±3.1）ml/（min·kg）、（17.0±0.9）ml比（15.1±0.8）ml、（8.6±1.7）比（7.2±1.6）］，差异均有统计学意义（均P＜0.05）。康复运动治疗后，2组二尖瓣舒张早期血流峰值减速时间、左心室血流传播速度均高于治疗前，且观察组高于对照组［（129±30）ms比（116±26）ms、（51.4±2.9）cm/s比（47.6±2.6）cm/s］，2组左心房容积、左心房容积指数均低于治疗前，且观察组低于对照组［（28±16）ml比（37±15）ml、（25±8）ml/m2比（30±8）ml/m2］，差异均有统计学意义（均P＜0.05）。治疗期间，观察组心血管不良事件发生率低于对照组，差异有统计学意义（P＜0.05）。结论 老年急性心肌梗死患者PCI术后应用心肺康复运动治疗可改善患者心肺功能，降低心血管不良事件发生率。

• Objective To investigate the effects of cardiopulmonary rehabilitation exercise on cardiopulmonary function and cardiac diastolic function in senile patients with acute myocardial infarction(AMI) after percutaneous coronary intervention (PCI). Methods Totally 87 senile patients with AMI admitted to Beijing Jishuitan Hospital from September 2017 to August 2019 were selected. They were divided into control group (46 cases) and observation group (41 cases) according to the blind selection method. Patients in both groups were treated with PCI. After PCI, the control group was treated with conventional rehabilitation protocol, and the observation group was treated with novel cardiopulmonary rehabilitation exercise on the basis of the control group. Both groups were treated for 12 weeks. The cardiopulmonary function indexes and cardiac ultrasound indexes before and after treatment, and incidence of cardiovascular adverse events during treatment were compared between the two groups. Results After rehabilitation exercise treatment, the maximum oxygen uptake, maximum oxygen uptake per heart rate and maximum metabolic equivalent in two groups were higher than those before treatment, and those in the observation group were higher than those in the control group ［（24.6±3.5）ml/（min·kg） vs （21.3±3.1）ml/（min·kg）,（17.0±0.9）ml vs （15.1±0.8）ml,（8.6±1.7） vs （7.2±1.6）］ (all P<0.05). After rehabilitation exercise treatment, the mitral early diastolic peak flow deceleration time and left ventricular flow propagation velocity of the two groups were higher than those before treatment, and those of the observation group were higher than those of the control group［（129±30）ms vs （116±26）ms,（51.4±2.9）cm/s vs （47.6±2.6）cm/s］; the left atrial volume, and left atrial volume index of the two groups were lower than those before treatment, and those of the observation group were lower than those of the control group［（28±16）ml vs （37±15）ml,（25±8）ml/m2 vs （30±8）ml/m2］ (all P<0.05). The incidence of cardiovascular adverse events in the observation group was lower than that in the control group (P<0.05). Conclusion Cardiopulmonary rehabilitation exercise treatment in senile patients with AMI after PCI can improve cardiopulmonary function and cardiac diastolic function, and decrease the incidence of adverse cardiovascular events.