心脏康复结合心理发明对急诊经皮冠状动脉介入治疗高危急性心肌梗死患者临床疗效的影响

中华行为医学与脑科学杂志 Pub Date : 2019-12-20 DOI:10.3760/CMA.J.ISSN.1674-6554.2019.12.005

Aichun Zhao

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引用次数: 0

摘要

目的探讨急性心肌梗死(AMI)高危患者急诊经皮冠状动脉介入治疗(PCI) I期心脏康复联合结构性心理发明的疗效。方法将120例急诊行PCI的AMI患者随机分为实验组(n=60)和对照组(n=60)。实验组在急诊PCI术后开始I期心脏康复联合结构心理发明。对照组给予常规治疗。比较两组患者PCI前和PCI后1周焦虑自评量表(SAS)和抑郁自评量表(SDS)得分。比较两组患者PCI前、PCI后1周、1个月、6个月左室射血分数(LVEF)和左室舒张末期内径(LVEDD)。比较两组在PCI术后6个月的心脏不良事件发生率，包括心源性死亡和心肌梗死复发。结果实验组PCI术后1周SAS评分(36.38±5.15)低于对照组(42.10±5.79)，差异有统计学意义(t=2.313, P < 0.05)。6个月随访结果显示，实验组心脏性死亡发生率(8.9%)低于对照组(24.1%)(95%CI: 0.317(0.128 ~ 0.835)， P<0.05)。随访6个月后，实验组心肌梗死复发率(14.2%)低于对照组(42.2%)(95%CI: 0.263(0.125 ~ 0.548)， P<0.05)。结论I期心脏康复可改善AMI高危患者急诊PCI治疗的心功能，降低心源性死亡和心肌梗死复发率。关键词:急性心肌梗死;急诊经皮冠状动脉介入治疗;高危患者;I期心脏康复;结构性心理发明

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Effects of cardiac rehabilitation combined with psychological invention on clinical efficacy in high-risk patients with acute myocardial infarction after emergent percutaneous coronary intervention

Objective To investigate the effects of stage I cardiac rehabilitation combined with structural psychological invention high-risk patients with acute myocardial infarction (AMI) treated by emergent percutaneous coronary intervention (PCI). Methods Totally 120 patients with AMI that received emergent PCI were randomized into experimental group(n=60) and control group(n=60). The experimental group started stage I cardiac rehabilitation combined with structural psychological invention after emergency PCI.The control group received routine treatment.Self-rating Anxiety Scale (SAS) and Self-rating depression Scale (SDS) scores were compared in both groups at before PCI and 1 week after PCI.Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were compared in both groups at before PCI and 1 week, 1 month and 6 months after PCI.The incidence of adverse cardiac events including cardiac death and recurrence myocardial infarction were compared between the two groups at 6 months after PCI. Results The SAS score in the experimental group (36.38±5.15) was lower than that in the control group (42.10±5.79) in 1 week after PCI (t=2.313, P 0.05). The follow-up results after 6 months showed that the experimental group (8.9%) had lower incidence of cardiac death than that in the control group (24.1%) (HR(95%CI): 0.317(0.128-0.835), P<0.05). The follow-up results after 6 months showed that the experimental group (14.2%) had lower incidence of recurrence myocardial infarction than that in the control group (42.2%) (HR(95%CI): 0.263(0.125-0.548), P<0.05). Conclusion Stage I cardiac rehabilitation improved the cardiac function in high-risk patients with AMI treated by emergent PCI and reduced the incidence of cardiac death and recurrence myocardial infarction. Key words: Acute myocardial infarction; Emergent percutaneous coronary intervention; High-risk patients; Stage I cardiac rehabilitation; Structural psychological invention

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中华行为医学与脑科学杂志

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8131

期刊介绍： "Chinese Journal of Behavioral Medicine and Brain Science" (CN 37-1468/R, ISSN 1674-6554) is a national academic journal under the supervision of the National Health Commission, sponsored by the Chinese Medical Association and Jining Medical College. The journal was founded in June 1992 and was formerly known as "Chinese Journal of Behavioral Medicine" (1992-1993) and "Chinese Behavioral Medical Science" (1994-2008). In 2009, it was renamed "Chinese Journal of Behavioral Medicine and Brain Science" with the approval of the State Administration of Press, Publication, Radio, Film and Television. The purpose of "Chinese Journal of Behavioral Medicine and Brain Science" is to implement the health and health policies of the Party and the State, implement the principle of combining theory with practice and popularization and improvement, and reflect the major progress in the theory and practical application of behavioral medicine and brain science in my country. It publishes academic papers and scientific research results in the field of behavioral medicine and brain science in my country, and has columns such as monographs/reviews, basic research, clinical research, health prevention, methods and techniques, psychological behavior and evaluation, and systematic evaluation.