早期心脏康复程序对急性心肌梗死患者经皮冠状动脉介入术后心脏收缩功能的影响

发布时间：2019-03-17 07:18

【摘要】：目的:通过三维斑点追踪成像技术评估急性心肌梗死患者(AMI)经皮冠状动脉介入术(PCI)后的左室整体及局部收缩功能变化,探讨以社区为主的早期心脏康复训练对AMI患者的心功能影响。方法:根据是否愿意参加心脏康复,将急性心肌梗死术后患者分为康复组(25例)和对照组(25例)。其中,康复组参与12周的心脏康复程序,进行早期心脏康复训练。对照组仅接受常规护理。在研究开始前、结束后,所有患者均接受三维斑点追踪成像(Three-dimensional speckle tracking imaging,3D-STI)检查,获得左心室整体及各节段纵向、径向、周向及面积应变值(LS、RS、CS、AS)。结果:经过12周的康复程序后,康复组的整体纵向应变(global longitudinal strain,GLS)、整体圆周应变(global circumferential strain,GCS)、整体径向应变(global radial strain,GRS)、整体面积应变(global area strain,GAS)及左室射血分数(left ventricular ejection fraction,LVEF)较对照组显著增加(P0.01)。根据左室心肌节段分区法,两组间左前降支供血区域各有150节段,左回旋支供血区域各有125节段,右冠脉供血区域各有125节段。经过12周的康复程序后,康复组不同冠脉供血区域的LS、RS、CS、AS较对照组显著增加(P0.05)。结论:早期心脏康复治疗可以改善经PCI术后患者的心脏收缩功能。
[Abstract]:Objective: to evaluate the changes of left ventricular global and regional systolic function after (AMI) percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) by three-dimensional dot tracing imaging. To investigate the effect of community-based early cardiac rehabilitation training on cardiac function in patients with AMI. Methods: patients with acute myocardial infarction (AMI) were divided into rehabilitation group (n = 25) and control group (n = 25) according to whether they were willing to take part in cardiac rehabilitation. Among them, the rehabilitation group participated in the 12-week cardiac rehabilitation procedure, and carried out early cardiac rehabilitation training. The control group only received routine nursing. Before and after the study, all patients were examined by three-dimensional dot tracing imaging (Three-dimensional speckle tracking imaging,3D-STI) to obtain longitudinal, radial, circumferential and area strain values (LS,RS,CS,AS) of the whole and various segments of the left ventricle. Results: after 12 weeks of rehabilitation, the overall longitudinal strain (global longitudinal strain,GLS), the whole circumferential strain (global circumferential strain,GCS), the whole radial strain (global radial strain,GRS) and the total area strain (global area strain,) in the rehabilitation group were determined. GAS and left ventricular ejection fraction (left ventricular ejection fraction,LVEF) were significantly higher than those in the control group (P0.01). According to the division of left ventricular myocardial segment, there were 150 segments in the left anterior descending artery, 125 segments in the left circumflex artery and 125 segments in the right coronary artery between the two groups. After 12 weeks of rehabilitation, the LS,RS,CS,AS of different coronary blood supply areas in the rehabilitation group was significantly higher than that in the control group (P0.05). Conclusion: early cardiac rehabilitation therapy can improve cardiac contractile function after PCI.
【作者单位】：广州军区广州总医院心血管内科;广州中医药大学研究生院;广州军区广州总医院超声科;
【基金】：广东省重大科技专项资金项目(2013A022100036)
【分类号】：R542.22

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