新型心脏康复训练对急性ST段抬高型心肌梗死患者PCI术后心功能及血管内皮功能的影响

目的　探讨新型心脏康复训练对急性ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入（PCI）术后心功能及血管内皮功能的影响。方法　选取河池市人民医院60例行PCI术的急性STEMI患者进行前瞻性研究，随机数字表法分为观察组和对照组，各30例。对照组男19例、女11例，年龄（58.69±6.78）岁，开展传统心脏康复训练；观察组男21例、女9例，年龄（59.33±7.08）岁，在对照组基础上联合新型心脏康复训练。比较两组左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）、左室射血分数（LVEF）、6 min步行试验（6MWT）、内皮素（ET-1）、一氧化氮（NO）及不良事件发生率。统计学方法采用χ²检验、t检验。结果　观察组术后LVESD、LVEDD低于对照组［（34.17±2.86）mm比（38.24±2.73）mm、（47.18±3.32）mm比（50.36±2.13）mm］，LVEF、6MWT高于对照组［（59.06±3.37）%比（54.36±3.74）%、（457.16±88.49）m比（409.32±79.78）m］，差异均有统计学意义（t=4.028、2.817、4.883、3.384，均P<0.05）。观察组术后ET-1水平低于对照组（t=5.728，P<0.05），NO水平高于对照组（t=4.132，P<0.05）。观察组不良心血管事件发生率为10.00%（3/30），低于对照组［30.00%（9/30）］，差异有统计学意义（χ² =4.812，P=0.028）。结论　新型心脏康复训练有助于改善急性STEMI患者PCI术后心功能及血管内皮功能，降低不良心血管事件发生率。

Effect of new-type cardiac rehabilitation training on cardiac function and vascular endothelial function of patients with ST-segment elevation myocardial infarction after PCI

Objective　To evaluate the effect of new-type cardiac rehabilitation training on cardiac function and vascular endothelial function of patients with acute ST-segment elevation myocardial infarction (STEMI) after PCI. Methods　Sixty patients with acute STEMI treated by PCI at People's Hospital of Hechi City were divided into an observation group and a control group by the random number table method, with 30 cases in each group. There were 19 males and 11 females in the control group; they were (58.69±6.78) year old. There were 21 males and 9 females in the observation group; they were (59.33±7.08) year old. The control group did traditional cardiac rehabilitation training; in addition, the observation group took the new-type cardiac rehabilitation training. The left ventricular end-systolic dimensions (LVESD), left ventricular end diastolic dimensions (LVEDD), left ventricular ejection fractions (LVEF), 6 min walking test (6MWT), endothelin (ET-1), NO, and incidences of adverse events were compared between the two groups. χ² and t tests were applied. Results　After PCI, the LVESD and LVEDD were lower and the LVEF and 6MWT were higher in the observation group than in the control group (34.17±2.86) mm vs. (38.24±2.73) mm, (47.18±3.32) mm vs. (50.36±2.13) mm, (59.06±3.37)% vs. (54.36±3.74)%, and (457.16±88.49) m vs. (409.32±79.78) m], with statistical differences (t=4.028, 2.817, 4.883, and 3.384; all P<0.05). After PCI, the ET-1 level was higher and the NO level was lower in the observation group than in the control group (t=5.728 and 4.132; both P<0.05). The incidence of adverse events in the observation group was lower than that in the control group 10.00% (3/30) vs 30.00% (9/30)], with a statistical difference (χ² =4.812, P=0.028). Conclusion　New-type Cardiac rehabilitation training for patients with acute STEMI after PCI can improve their cardiac function and vascular endothelial function and reduce adverse events.