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随机试验研究早期运动康复及其对急性冠状动脉综合征患者的影响。

Randomized trial of early exercise rehabilitation and its effects on patients with acute coronary syndrome.

机构信息

Department of Cardiology/Endocrinolog, Fuzhou University Affiliated Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.

Department of Cardiology, Fuzhou University Affiliated Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, No. 134 East Street, Gulou District, Fuzhou, 350001, P.R. China.

出版信息

Sci Rep. 2024 Nov 1;14(1):26289. doi: 10.1038/s41598-024-77108-z.

Abstract

To assess the psychological and physiological benefits of early exercise rehabilitation in patients with acute coronary syndrome (ACS). Among 559 ACS-diagnosed patients at Fuzhou University Affiliated Provincial Hospital from January to December 2021, 200 eligible participants were assigned to two groups. The control group received standard care, while the experimental group received early exercise rehabilitation in addition to standard care. The outcomes measured included changes in depression levels (PHQ-9), fasting blood glucose, and troponin I (TnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Data were analyzed using SPSS, with t tests and chi-square tests for group comparisons. In comparison to the control group, the experimental group demonstrated significant improvements in PHQ-9 scores (P < 0.001) and lower fasting blood glucose levels before discharge (P = 0.046). Additionally, the experimental group had notably reduced TnI levels at 72 h after admission (P = 0.001), especially among non-diabetic NSTEMI patients over 60 years old, who showed decreased TnI levels at the 48-hour mark (P = 0.016). However, there were no significant differences in NT-ProBNP change values between the two groups (P > 0.05). Subgroup analysis revealed enhanced outcomes in the intervention group for ACS patients without smoking or drinking history and no heart failure (P = 0.025,P = 0.014,P = 0.018). Early exercise rehabilitation has notable benefits for ACS patients, including reduced depression, improved blood glucose control, and enhanced myocardial protection, especially in nondiabetic NSTEMI patients aged 60 and above.

摘要

评估急性冠状动脉综合征(ACS)患者早期运动康复的心理和生理益处。2021 年 1 月至 12 月,在福州大学附属福建省立医院诊断为 ACS 的 559 例患者中,纳入 200 例符合条件的参与者,分为两组。对照组接受标准护理,实验组在标准护理基础上进行早期运动康复。测量的结果包括抑郁水平(PHQ-9)、空腹血糖和肌钙蛋白 I(TnI)和 N 末端 pro-B 型利钠肽(NT-proBNP)水平的变化。使用 SPSS 进行数据分析,组间比较采用 t 检验和卡方检验。与对照组相比,实验组 PHQ-9 评分明显改善(P<0.001),出院前空腹血糖水平降低(P=0.046)。此外,实验组入院后 72 小时 TnI 水平明显降低(P=0.001),尤其是 60 岁以上非糖尿病 NSTEMI 患者,在 48 小时时 TnI 水平降低(P=0.016)。但两组 NT-ProBNP 变化值无显著差异(P>0.05)。亚组分析显示,在无吸烟或饮酒史且无心力衰竭的 ACS 患者和非心力衰竭 ACS 患者中,干预组的结果改善更为明显(P=0.025,P=0.014,P=0.018)。早期运动康复对 ACS 患者具有显著益处,包括降低抑郁、改善血糖控制和增强心肌保护,特别是对 60 岁及以上的非糖尿病 NSTEMI 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8ec/11530432/50d69db7b8ac/41598_2024_77108_Fig1_HTML.jpg

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