急性心肌梗死患者的院内早期心脏康复新进展New progress of early hospitalization cardiac rehabilitation for patients with acute myocardial infarction
高逸凡,胡荣,张瀛月,徐勇,马晶
摘要(Abstract):
心脏康复(CR)是在生物-心理-社会医学模式指导下的一种新型综合性管理方法,是针对患者的一系列协调且多方面的干预措施,旨在全面优化心血管疾病患者的身体、心理和社会功能,减轻疾病的不利影响。完整的CR从急性心肌梗死(AMI)患者的住院早期开始,贯穿住院治疗及后续门诊治疗,最长可持续终身。《中国心脏康复与二级预防指南》指出,条件允许的情况下,AMI患者应当尽快开始CR。本文结合相关文献,旨在从运动训练、心理干预、药物治疗、营养膳食及戒烟干预等5个方面对AMI患者的住院早期CR方案做一综述。
关键词(KeyWords): 心脏康复;急性心肌梗死;二级预防
基金项目(Foundation):
作者(Author): 高逸凡,胡荣,张瀛月,徐勇,马晶
参考文献(References):
- [1]Taylor RS,Dibben G,Faulkner J,et al.More evidence of cardiac rehabilitation:need to consider patient quality of life[J].Can J Cardiol,2021,37(10):1681-1682.DOI:10.1016/j.cjca.2021.01.012.
- [2]中国医院协会心脏康复管理专业委员会,苏州工业园区心血管健康研究院.心脏康复分级诊疗中国专家共识[J].中国介入心脏病学杂志,2022,30(8):561-572.DOI:10.3969/j.issn.1004-8812.2022.08.001.
- [3]马丽媛,王增武,樊静,等.《中国心血管健康与疾病报告2021》概要[J].中国介入心脏病学杂志,2022,30(7):481-496.DOI:10.3969/j.issn.1004-8812.2022.07.001.
- [4]支晨,皮红英,胡鑫.急性心梗患者PCI术后生活质量调查与分析[J].中国卫生质量管理,2017,24(5):56-58.DOI:10.13912/j.cnki.chqm.2017.24.5.19.
- [5]Jiang Z,Dreyer RP,Spertus JA,et al.Factors associated with return to work after acute myocardial infarction in China[J].JAMA Network Open,2018,1(7):e184831.DOI:10.1001/jamanetworkopen.2018.4831.
- [6]Dibben G,Faulkner J,Oldridge N,et al.Exercise-based cardiac rehabilitation for coronary heart disease[J].Cochrane Database Syst Rev,2021,11(11):CD001800.DOI:10.1002/14651858.CD001800.pub4.
- [7]Nakamura K,Ohbe H,Uda K,et al.Early rehabilitation after acute myocardial infarction:A nationwide inpatient database study[J].J Cardiology,2021,78(5):456-462.DOI:10.1016/j.jjcc.2021.06.004.
- [8]Bracewell NJ,Plasschaert J,Conti CR,et al.Cardiac rehabilitation:effective yet underutilized in patients with cardiovascular disease[J].Clin Cardiology,2022,45(11):1128-1134.DOI:10.1002/clc.23911.
- [9]American Association Of Cardiovascular and Pulmonary Rehabilitation.Guidelines for cardiac rehabilitation and secondary prevention programs(5th Edition)[M].Human Kinetics,USA,2013.
- [10]Smith SC Jr,Benjamin EJ,Bonow RO,et al.AHA/ACCFsecondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease:2011 update:a guideline from the American Heart Association and American College of Cardiology Foundation[J].Circulation,2011,124(22):2458-2473.DOI:10.1161/CIR.0b013e318235eb4d.
- [11]Scottish Intercollegiate Guidelines Network (SIGN).A national clinical guideline on cardiac rehabilitation[M].2017.
- [12]National Institute for Health and Care Excellence.Myocardial infarction:cardiac rehabilitation and prevention of further cardiovascular disease[EB/OL].(2013-11-13)[2023-4-20].http://www.nice.org.uk/guidance/cg172.
- [13]Kim C,Sung J,Lee JH,et al.Clinical practice guideline for cardiac rehabilitation in Korea[J].Korean J Thorac Cardiovasc Surg,2019,52(4):248-285.DOI:10.5090/kjtcs.2019.52.4.248.
- [14]JCS Joint Working Group.Guidelines for rehabilitation in patients with cardiovascular disease (JCS 2012)[J].Circ J,2014,78(8):2022-2093.DOI:10.1253/circj.cj-66-0094.
- [15]Senaratne MP,Smith G,Gulamhusein SS.Feasibility and safety of early exercise testing using the Bruce protocol after acute myocardial infarction[J].J Am Coll Cardiol,2000,35(5):1212-1220.DOI:10.1016/s0735-1097(00)00545-3.
- [16]Kovoor P,Lee AKY,Carrozzi F,et al.Return to full normal activities including work at two weeks after acute myocardial infarction[J].Am J Cardiol,2006,97(7):952-958.DOI:10.1016/j.amjcard.2005.10.040.
- [17]Herkner H,Thoennissen J,Nikfardjam M,et al.Short versus prolonged bed rest after uncomplicated acute myocardial infarction:a systematic review and Meta-analysis[J].J Clin Epidemiol,2003,56(8):775-781.DOI:10.1016/s0895-4356(03)00121-5.
- [18]牛亚芊芊,郭丹杰,邹尚志,等.急性期接受经皮冠状动脉介入治疗不同程度血运重建的首次急性心肌梗死患者运动耐量的比较[J].中国介入心脏病学杂志,2019,27(11):633-640.DOI:10.3969/j.issn.1004-8812.2019.11.008.
- [19]Haykowsky M,Scott J,Esch B,et al.A Meta-analysis of the effects of exercise training on left ventricular remodeling following myocardial infarction:start early and go longer for greatest exercise benefits on remodeling[J].Trials,2011,12:92.DOI:10.1186/1745-6215-12-92.
- [20]Zhang YM,Lu Y,Tang Y,et al.The effects of different initiation time of exercise training on left ventricular remodeling and cardiopulmonary rehabilitation in patients with left ventricular dysfunction after myocardial infarction[J].Disabil Rehabil,2016,38(3):268-276.DOI:10.3109/09638288.2015.1036174.
- [21]Taylor RS,Dalal HM,McDonagh STJ.The role of cardiac rehabilitation in improving cardiovascular outcomes[J].Nat Rev Cardiol,2022,19(3):180-194.DOI:10.1038/s41569-021-00611-7.
- [22]中国康复医学会心血管病专业委员会.中国心脏康复与二级预防指南[M].北京:北京大学医学出版社,2018.
- [23]吴健.重症心脏康复[M].北京:科学出版社,2021.
- [24]Mezzani A,Hamm LF,Jones AM,et al.Aerobic exercise intensity assessment and prescription in cardiac rehabilitation:a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation,the American Association of Cardiovascular and Pulmonary Rehabilitation,and the Canadian Association of Cardiac Rehabilitation[J].JCardiopulm Rehabil Prev,2012,32(6):327-350.DOI:10.1097/HCR.0b013e3182757050.
- [25]中国医师协会心血管内科医师分会预防与康复专业委员会.经皮冠状动脉介入治疗术后运动康复专家共识[J].中国介入心脏病学杂志,2016,24(7):361-369.DOI:10.3969/j.issn.1004-8812.2016.07.001.
- [26]Anderson L,Thompson DR,Oldridge N,et al.Exercise-based cardiac rehabilitation for coronary heart disease[J].Cochrane Database Syst Rev,2016,2016(1):CD001800.DOI:10.1002/14651858.CD001800.pub3.
- [27]van der Peijl ID,Vliet Vlieland TP,Versteegh MI,et al.Exercise therapy after coronary artery bypass graft surgery:a randomized comparison of a high and low frequency exercise therapy program[J].Ann Thorac Surg,2004,77(5):1535-1541.DOI:10.1016/j.athoracsur.2003.10.091.
- [28]Mello PR,Guerra GM,Borile S,et al.Inspiratory muscle training reduces sympathetic nervous activity and improves inspiratory muscle weakness and quality of life in patients with chronic heart failure:a clinical trial[J].J Cardiopulm Rehabil Prev,2012,32(5):255-261.DOI:10.1097/HCR.0b013e31825828da.
- [29]Kurzaj M,Dziubek W,Por?bska M,et al.Can inspiratory muscle training improve exercise tolerance and lower limb function after myocardial infarction?[J].Med Sci Monit,2019,25:5159-5169.DOI:10.12659/MSM.914684.
- [30]段俊滔,刘聪颖,于桂香,等.吸气肌训练对经皮冠状动脉介入治疗术后患者的影响研究[J].中华护理杂志,2020,55(4):519-523.DOI:10.3761/j.issn.0254-1769.2020.04.008.
- [31]Rosengren A,Hawken S,Ounpuu S,et al.Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study):case-control study[J].Lancet,2004,364(9438):953-962.DOI:10.1016/S0140-6736(04)17019-0.
- [32]Iso H,Date C,Yamamoto A,et al.Perceived mental stress and mortality from cardiovascular disease among Japanese men and women:the Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study)[J].Circulation,2002,106(10):1229-1236.DOI:10.1161/01.cir.0000028145.58654.41.
- [33]Rozanski A,Blumenthal JA,Davidson KW,et al.The epidemiology,pathophysiology,and management of psychosocial risk factors in cardiac practice:the emerging field of behavioral cardiology[J].J Am Coll Cardiol,2005,45(5):637-651.DOI:10.1016/j.jacc.2004.12.005.
- [34]Yusuf S,Hawken S,Ounpuu S,et al.Effect of potentially modifiable risk factors associated with myocardial infarction in 52countries (the INTERHEART study):case-control study[J].Lancet,2004,364(9438):937-952.DOI:10.1016/S0140-6736(04)17018-9.
- [35]Pimple P,Lima BB,Hammadah M,et al.Psychological distress and subsequent cardiovascular events in individuals with coronary artery disease[J].J Am Heart Assoc,2019,8(9):e011866.DOI:10.1161/JAHA.118.011866.
- [36]Gehi A,Haas D,Pipkin S,et al.Depression and medication adherence in outpatients with coronary heart disease:findings from the Heart and Soul Study[J].Archives of internal medicine,2005,165(21):2508-2513.DOI:10.1001/archinte.165.21.2508.
- [37]Stone JA,Arthur HM.Canadian guidelines for cardiac rehabilitation and cardiovascular disease prevention,second edition,2004:executive summary[J].Can J Cardiol,2005,21 Suppl D:3D-19D.
- [38]Richards SH,Anderson L,Jenkinson CE,et al.Psychological interventions for coronary heart disease[J].Cochrane Database Syst Rev,2017,4(4):CD002902.DOI:10.1002/14651858.CD002902.pub4.
- [39]Toussaint A,Hüsing P,Gumz A,et al.Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)[J].J Affect Disord,2020,265:395-401.DOI:10.1016/j.jad.2020.01.032.
- [40]Levis B,Benedetti A,Thombs BD.Accuracy of patient health questionnaire-9 (PHQ-9) for screening to detect major depression:individual participant data Meta-analysis[J].BMJ,2019,365:l1476.DOI:10.1136/bmj.l1476.
- [41]Julian LJ.Measures of anxiety:state-trait anxiety inventory(STAI),beck anxiety inventory (BAI),and hospital anxiety and depression scale-anxiety (HADS-A)[J].Arthritis Care Res (Hoboken),2011,63 Suppl 11(0 11):S467-S472.DOI:10.1002/acr.20561.
- [42]Dunstan DA,Scott N,Todd AK.Screening for anxiety and depression:reassessing the utility of the Zung scales[J].BMCPsychiatry,2017,17(1):329.DOI:10.1186/s12888-017-1489-6.
- [43]Cohen S,Kamarck T,Mermelstein R.A global measure of perceived stress[J].J Health Soc Behav,1983,24(4):385-396.
- [44]Augustin M,Zschocke I,Koch A,et al.Psychological status and motivation for psychosocial intervention in patients with allergic disorders[J].Hautarzt,1999,50(6):422-427.DOI:10.1007/s001050050935.
- [45]Oland AA,Booster GD,Bender BG.Integrated behavioral health care for management of stress in allergic diseases[J].Ann Allergy Asthma Immunol,2018,121(1):31-36.DOI:10.1016/j.anai.2018.05.002.
- [46]de Witte M,Pinho ADS,Stams GJ,et al.Music therapy for stress reduction:a systematic review and Meta-analysis[J].Health Psychol Rev,2022,16(1):134-159.DOI:10.1080/17437199.2020.1846580.
- [47]Mitchell M.Patient anxiety and modern elective surgery:a literature review[J].J Clin Nurs,2003,12(6):806-815.DOI:10.1046/j.1365-2702.2003.00812.x.
- [48]Nakao T,Morita H.Neuromuscular electrical stimulation in patients with acute myocardial infarction[J].Int Heart J,2016,57(6):659-660.DOI:10.1536/ihj.16-498.
- [49]Gillen E,Biley F,Allen D.Effects of music listening on adult patients'pre-procedural state anxiety in hospital[J].JBI Libr Syst Rev,2008,6(17):686-732.DOI:10.11124/01938924-200806170-00001.
- [50]Lee OKA,Chung YF,Chan MF,et al.Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation:a pilot study[J].J Clin Nurs,2005,14(5):609-620.DOI:10.1111/j.1365-2702.2004.01103.x.
- [51]Tsoi KKF,Chan JYC,Ng Y,et al.Receptive music therapy is more effective than interactive music therapy to relieve behavioral and psychological symptoms of dementia:a systematic review and Meta-analysis[J].J Am Med Dir Assoc,2018,19(7):568-576.DOI:10.1016/j.jamda.2017.12.009.
- [52]Blumenthal JA,Jiang W,Babyak MA,et al.Stress management and exercise training in cardiac patients with myocardial ischemia.Effects on prognosis and evaluation of mechanisms[J].Arch Intern Med,1997,157(19):2213-2223.
- [53]Blumenthal JA,Sherwood A,Babyak MA,et al.Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease:a randomized controlled trial[J].JAMA,2005,293(13):1626-1634.DOI:10.1001/jama.293.13.1626.
- [54]Blumenthal JA,Sherwood A,Smith PJ,et al.Enhancing cardiac rehabilitation with stress management training:a randomized,clinical efficacy trial[J].Circulation,2 0 1 6,1 3 3 (1 4):1 3 4 1-1 3 5 0.D O I:1 0.1 1 6 1/CIRCULATIONAHA.115.018926.
- [55]Grossert A,Urech C,Alder J,et al.Web-based stress management for newly diagnosed cancer patients(STREAM-1):a randomized,wait-list controlled intervention study[J].BMC Cancer,2016,16(1):838.DOI:10.1186/s12885-016-2866-0.
- [56]Iqbal R,Anand S,Ounpuu S,et al.Dietary patterns and the risk of acute myocardial infarction in 52 countries:results of the INTERHEART study[J].Circulation,2008,118(19):1929-1937.DOI:10.1161/CIRCULATIONAHA.107.738716.
- [57]Leslie WS,Hankey CR,Matthews D,et al.A transferable programme of nutritional counselling for rehabilitation following myocardial infarction:a randomised controlled study[J].Eur J Clin Nutr,2004,58(5):778-786.DOI:10.1038/sj.ejcn.1601876.
- [58]Giannuzzi P,Temporelli PL,Marchioli R,et al.Global secondary prevention strategies to limit event recurrence after myocardial infarction:results of the GOSPEL study,a multicenter,randomized controlled trial from the Italian Cardiac Rehabilitation Network[J].Arch Intern Med,2008,168(20):2194-2204.DOI:10.1001/archinte.168.20.2194.
- [59]Rallidis LS,Sakadakis EA,Tympas K,et al.The impact of smoking on long-term outcome of patients with premature(≤35years)ST-segment elevation acute myocardial infarction[J].Am Heart J,2015,169(3):356-362.DOI:10.1016/j.ahj.2014.12.003.
- [60]Rallidis LS,Pavlakis G.The fundamental importance of smoking cessation in those with premature ST-segment elevation acute myocardial infarction[J].Curr Opin Cardiol,2016,31(5):531-536.DOI:10.1097/HCO.0000000000000320.
- [61]Heatherton TF,Kozlowski LT,Frecker RC,et al.The Fagerstr?m test for nicotine dependence:a revision of the Fagerstr?m tolerance questionnaire[J].Br J Addict,1991,86(9):1119-1127.DOI:10.1111/j.1360-0443.1991.tb01879.x.