Zdrenghea D, Predescu D, Ducasz E, Ober M C, Ilea Maria
Rehabilitation Clinical Hospital--Cardiology Department, Cluj-Napoca, Romania.
Rom J Intern Med. 2004;42(3):513-9.
It is not well known what should be the benefits of a prolonged physical rehabilitation program after an acute myocardial infarction.
Our study is an open, randomized comparison of a long-term versus a standard rehabilitation program. Sixty-seven patients with acute myocardial infarction were included in an outpatient physical rehabilitation program of 6-8 weeks. Of these, 22 randomly selected patients continued the program until the 36th month (Group A). Twenty-five of the others were rechecked after 36 months, and represented the controls (Group B). For both groups, at the end of this period, a cycloergometer exercise test evaluated the exercise capacity of subjects and an echocardiogram was performed to determine left ventricular systolic and diastolic function.
The maximal exercise capacity increased from 147 +/- 13.8 W to 178 +/- 16.4 W in Group A (p < 0.01), but it decreased from 144 +/- 13.2 to 132 +/- 12.8 W in group B. Functional aerobic impairment decreased from 29 +/- 2.7% to 22 +/- 2.1% in Group A, but it increased from 26 +/- 2.5% to 37 +/- 3.8% in Group B. The ejection fraction and diastolic function parameters were not significantly modified during the 36 months, for both groups.
Long-term physical rehabilitation is useful in patients after an acute myocardial infarction to increase effort capacity, but left ventricular performance is not significantly changed.
急性心肌梗死后长期身体康复计划的益处尚不明确。
我们的研究是长期康复计划与标准康复计划的开放性随机对照研究。67例急性心肌梗死患者纳入为期6 - 8周的门诊身体康复计划。其中，22例随机选取的患者继续该计划直至第36个月（A组）。其余25例在36个月后复查，作为对照组（B组）。在这一阶段结束时，对两组患者均进行了症状限制性运动试验以评估运动能力，并进行超声心动图检查以确定左心室收缩和舒张功能。
A组最大运动能力从147±13.8瓦增加到178±16.4瓦（p<0.01），而B组从144±13.2瓦下降到132±12.8瓦。A组功能性有氧障碍从29±2.7%降至22±2.1%，而B组从26±2.5%升至37±3.8%。两组在36个月期间射血分数和舒张功能参数均无显著变化。
急性心肌梗死后患者进行长期身体康复有助于提高运动能力，但左心室功能无显著改变。
