Zhang Yong, Cao HongXia, Jiang Pin, Tang HaiQin
Department of Geriatrics Cardiology Nursing Department Department of General Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China.
Medicine (Baltimore). 2018 Feb;97(8):e9785. doi: 10.1097/MD.0000000000009785.
Acute myocardial infarction (AMI) is one of the leading causes of death and physical disability worldwide. However, the development of community- based cardiac rehabilitation (CR) in AMI patients is hysteretic. Here, we aimed to evaluate the safety and efficacy of CR applied in the community in AMI patients who underwent percutaneous coronary intervention (PCI).
A total of 130 ST-segment elevated myocardial infarction (STEMI) patients after PCI were randomly divided into 2 groups in the community, rehabilitation group (n = 65) and control group (n = 65). Cardiac function, a 6-minute walk distance, exercise time and steps, cardiovascular risk factors were monitored respectively and compared before and after the intervention of 2 groups. The software of EpiData 3.1 was used to input research data and SPSS16.0 was used for statistical analysis.
After a planned rehabilitation intervention, the rehabilitation group showed better results than the control group. The rehabilitation group had a significant improvement in recurrence angina and readmission (P < .01). Left ventricular ejection fraction (LVEF) of rehabilitation group showed improvement in phase II (t = 4.963, P < .01) and phase III (t = 11.802, P < .01), and the New York Heart Association (NYHA) classification was recovered within class II. There was a significant difference compared with before (Z = 7.238, P < .01). Six minutes walking distance, aerobic exercise time, and steps all achieved rehabilitation requirements in rehabilitation group in phase II and III, there existed distinct variation between 2 phases. Rehabilitation group had a better result in cardiovascular risk factors than control group (P < .05).
Community-based CR after PCI through simple but safe exercise methods can improve the AMI patient's living quality, which includes increasing cardiac ejection fraction, exercise tolerance, and physical status. It must be emphasized that the good result should be established by the foundation of close cooperation between cardiologists and general practitioners, also the importance of cooperation of patients and their families should not be ignored. The rehabilitation program we used is feasible, safe, and effective.
急性心肌梗死(AMI)是全球范围内导致死亡和身体残疾的主要原因之一。然而,基于社区的心脏康复(CR)在AMI患者中的发展滞后。在此,我们旨在评估CR应用于接受经皮冠状动脉介入治疗(PCI)的社区AMI患者的安全性和有效性。
将130例PCI术后的ST段抬高型心肌梗死(STEMI)患者在社区中随机分为两组,康复组(n = 65)和对照组(n = 65)。分别监测两组干预前后的心功能、6分钟步行距离、运动时间和步数、心血管危险因素并进行比较。使用EpiData 3.1软件录入研究数据,采用SPSS16.0进行统计分析。
经过计划的康复干预后,康复组的效果优于对照组。康复组在心绞痛复发和再入院方面有显著改善(P <.01)。康复组的左心室射血分数(LVEF)在第二阶段(t = 4.963,P <.01)和第三阶段(t = 11.802,P <.01)有所改善,纽约心脏协会(NYHA)分级恢复到II级以内。与之前相比有显著差异(Z = 7.238,P <.01)。康复组在第二阶段和第三阶段的6分钟步行距离、有氧运动时间和步数均达到康复要求,两个阶段之间存在明显差异。康复组在心血管危险因素方面的结果优于对照组(P <.05)。
PCI术后基于社区的CR通过简单但安全的运动方法可以提高AMI患者的生活质量,包括增加心脏射血分数、运动耐量和身体状况。必须强调的是,良好的结果应建立在心脏病专家和全科医生密切合作的基础上,患者及其家属合作的重要性也不容忽视。我们使用的康复方案可行、安全且有效。