2021 年第 7 期 第 16 卷

社区心脏康复对急性非ST段抬高型心肌梗死患者经皮冠状动脉介入术后康复的影响

Effect of community-based cardiac rehabilitation on rehabilitation after percutaneous coronary intervention in patients with acute non-ST segment elevation myocardial infarction

作者：杨树鹏申云郝楠陈哲周玉杰

英文作者：Yang Shupeng Shen Yun Hao Nan Chen Zhe Zhou Yujie

单位：首都医科大学附属北京安贞医院心内科100029

英文单位：Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：急性非ST段抬高型心肌梗死；社区心脏康复；再发心绞痛

英文关键词：Acutenon-STsegmentelevationmyocardialinfarction;Community-basedcardiacrehabilitation;Recurrentanginapectoris

• 摘要：

• 目的 评估社区心脏康复(CR)对急性非ST段抬高型心肌梗死(NSTEMI)患者经皮冠状动脉介入(PCI)术后康复的影响。方法 选取2018年12月至2019年6月于首都医科大学附属北京安贞医院就诊并诊断为急性NSTEMI行PCI术的患者82例,按照随机数字表法分为CR组(41例)和对照组(41例)。随访1年，比较2组患者纽约心脏病协会（NYHA）心功能分级、6 min步行距离和再发心绞痛、全因死亡、非致死性心肌梗死发生率及再住院率。采用Logistic回归方法分析CR对患者随访1年观察指标的影响。结果 随访1年后，CR组NYHA心功能分级明显低于对照组［1（1,2）级比2（1,3）级］，6 min步行距离明显长于对照组［（410±98）m比（312±88）m］（均P＜0.05）。CR组再发心绞痛、非致死性心肌梗死、再住院比例均明显低于对照组（均P＜0.05）。2组均无全因死亡患者。调整相关因素后，与对照组相比，CR可显著降低患者再发心绞痛和再住院的风险（均P＜0.05）。结论 CR可以提升急性NSTEMI患者PCI术后的活动耐力和心功能，并且可以独立于其他因素降低患者再发心绞痛和再住院的风险。

• Objective To evaluate the effect of community-based cardiac rehabilitation (CR) on the rehabilitation after percutaneous coronary intervention (PCI) in patients with acute non-ST segment elevation myocardial infarction(NSTEMI).Methods From December 2018 to June 2019, 82 patients with NSTEMI undergoing PCI in Beijing Anzhen Hospital, Capital Medical University were randomly divided into CR group (41 cases) and control group (41 cases). The patients were followed-up for 1 year. The New York Heart Association(NYHA) cardiac function grade, 6 min walking distance, recurrent angina pectoris, all-cause death, non fatal myocardial infarction incidences and rehospitalization rate were compared between the two groups. Logistic regression method was used to analyze the effect of CR on the observation indexes of patients followed-up for 1 year.Results After 1 year of follow-up, NYHA cardiac function grade of CR group was significantly lower than that of control group［1（1,2） vs 2（1,3）］, and 6 min walking distance of CR group was significantly longer than that of control group［（410±98）m vs （312±88）m］ (both P＜0.05). The rates of recurrent angina pectoris, non fatal myocardial infarction and rehospitalization in CR group were significantly lower than those in control group(all P＜0.05). There was no all-cause death in both groups. After adjusting for relevant factors, CR significantly reduced the risks of recurrent angina pectoris and rehospitalization compared with the control group (both P＜0.05).Conclusion CR can improve the activity endurance and cardiac function of patients with NSTEMI after PCI, and can reduce the risk of angina pectoris and rehospitalization independently of other factors.