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目的探讨中荷合作心脏康复模式对经皮冠状动脉介入(PCI)治疗急性心肌梗死患者早期预后的影响。方法将我院60例急性心肌梗死患者随机分为康复组和对照组,康复组患者进行中荷合作心脏康复模式治疗,对照组患者进行传统康复治疗,对两组患者住院期间术后并发症进行分析,行心脏多普勒检测两组患者心功能,检测两组患者血清肿瘤坏死因子(TNF-α)、可溶性血管间黏附分子1(sVCAM-1)、内皮素-1(ET-1)、一氧化氮(NO),用健康调查简表36(SF-36)对患者预后生存质量进行评价。结果康复组在住院期间心律失常、心绞痛、心力衰竭的发生与对照组相比无统计学差异(P>0.05),但是下肢静脉血栓和排尿困难的发生明显少于对照组(P<0.05);多普勒超声结果显示康复组患者和对照组患者的心功能1个月后对比无统计学差异(P>0.05),6个月后对比,康复组心功能优于对照组(P<0.05);康复组患者血清中的TNF-α、sVCAM-1、ET-1均小于对照组(P<0.05),NO大于对照组(P<0.05);生存质量SF-36评分显示康复组评分高于对照组(P<0.05)。结论中荷合作心脏康复模式对PCI治疗的急性心肌梗死患者的早期预后优于传统康复加强治疗模式。
Objective To investigate the impact of the Sino-Dutch cooperative cardiac rehabilitation on the early prognosis of patients with acute myocardial infarction undergoing percutaneous coronary intervention (PCI). Methods Sixty patients with acute myocardial infarction in our hospital were randomly divided into rehabilitation group and control group. Patients in rehabilitation group were treated with Chinese-Dutch cooperative cardiac rehabilitation model, and patients in control group were treated by traditional rehabilitation. Postoperative complications were compared between the two groups The cardiac function of the two groups was detected by Doppler echocardiography. The levels of tumor necrosis factor-α (TNF-α), soluble vascular cell adhesion molecule 1 (sVCAM-1), endothelin- Nitric oxide (NO) was evaluated using the Health Survey Profile 36 (SF-36). Results There were no significant differences in arrhythmia, angina pectoris and heart failure between the rehabilitation group and the control group (P> 0.05). However, the incidence of venous thrombosis and dysuria in the rehabilitation group was significantly less than that of the control group (P <0.05). The results of Doppler ultrasound showed that there was no significant difference in cardiac function between rehabilitation group and control group after 1 month (P> 0.05). After 6 months, heart function of rehabilitation group was better than that of control group (P <0.05) (P <0.05). The serum levels of TNF-α, sVCAM-1 and ET-1 in the rehabilitation group were significantly lower than those in the control group (P <0.05) Control group (P <0.05). Conclusion The early prognosis of patients with acute myocardial infarction treated with PCI is better than that of traditional rehabilitation and intensive treatment mode.