经皮冠状动脉介入治疗后急性心肌梗死患者的动能递增运动的效果分析：一项随机试验。

Effect analysis of kinetic energy progressive exercise in patients with acute myocardial infarction after percutaneous coronary intervention: a randomized trial.

机构信息

Department of Cardiology, Xuzhou Central Hospital, Xuzhou, China.

Department of Coronary Care Unit, Xuzhou Central Hospital, Xuzhou, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7823-7831. doi: 10.21037/apm-21-1478.

DOI:10.21037/apm-21-1478

PMID:34353069

Abstract

BACKGROUND

Acute myocardial infarction (AMI) is the most common critical illness clinically. Percutaneous coronary intervention (PCI) can help patients with AMI by reopening their blocked blood vessels and improving clinical symptoms. Clinical practice has confirmed that rehabilitation training after PCI could significantly promote the recovery of patients' heart function, reduce cardiovascular events, and have a positive significance for prognosis. This study aimed to explore the effect of kinetic energy progressive exercise (PEKE) applied to patients with AMI after PCI.

METHODS

From April 2019 to April 2020, a total of 98 patients with AMI after PCI in our hospital were randomly allocated to PEKE group and routine intervention (RI) group. The RI group adopted routine intervention, while the PEKE group introduced PEKE intervention on the basis of the RI group. The incidence of adverse events (AEs), motor function, cardiac function, and quality of life (QoL) before and after intervention were compared between the two groups.

RESULTS

Compared with the RI group, the incidence of AEs in the PEKE group was significantly reduced (χ2=4.404, P=0.036). After 6 months of intervention, the maximum exercise load and metabolic equivalent of the PEKE group were greater than those of the RI group (t=7.114, 4.565; P=0.000, 0.000). After 6 months of intervention, the left ventricular ejection fraction (LVEF) of the PEKE group was greater than that of the RI group (t=6.826, P=0.000), and there were no significant differences in left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) compared with the RI group (t=1.253, 1.147; P=0.213, 0.254). After 6 months of intervention, the PEKE group's symptoms, physical function, cognitive function, psychosocial function, and satisfaction scores were greater than those in the RI group (t=5.991, 4.612, 7.165, 5.731, 5.468; P=0.000, 0.000, 0.000, 0.000, 0.000).

CONCLUSIONS

We applied PEKE was to AMI patients with after PCI, and it was shown to effectively reduce AEs, improve the patients' exercise ability and cardiac function, and improve their QoL.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: ChiCTR2100046123.

摘要

背景

急性心肌梗死（AMI）是临床上最常见的危急重症。经皮冠状动脉介入治疗（PCI）可以通过重新开通患者堵塞的血管、改善临床症状，帮助 AMI 患者。临床实践已经证实，PCI 后康复训练可以显著促进患者心功能恢复，减少心血管事件发生，对预后具有积极意义。本研究旨在探讨动力能渐进式运动（PEKE）在 PCI 后 AMI 患者中的应用效果。

方法

2019 年 4 月至 2020 年 4 月，我院收治的 98 例 AMI 后 PCI 患者被随机分配至 PEKE 组和常规干预（RI）组。RI 组采用常规干预，PEKE 组在此基础上引入 PEKE 干预。比较两组患者干预前后不良事件（AE）发生率、运动功能、心功能和生活质量（QoL）。

结果

与 RI 组相比，PEKE 组 AE 发生率显著降低（χ2=4.404，P=0.036）。干预 6 个月后，PEKE 组最大运动负荷和代谢当量均大于 RI 组（t=7.114，4.565；P=0.000，0.000）。干预 6 个月后，PEKE 组左心室射血分数（LVEF）大于 RI 组（t=6.826，P=0.000），左心室舒张末期容积（LVEDV）和左心室收缩末期容积（LVESV）与 RI 组比较差异无统计学意义（t=1.253，1.147；P=0.213，0.254）。干预 6 个月后，PEKE 组症状、躯体功能、认知功能、社会心理功能和满意度评分均大于 RI 组（t=5.991，4.612，7.165，5.731，5.468；P=0.000，0.000，0.000，0.000，0.000）。