尉焱,安健,孔永梅,郝利军,刘盼盼

• 1:山西医科大学
• 2:山西省心血管病医院心内科

摘要(Abstract)：

目的探讨不稳定型心绞痛患者不完全血运重建术后心脏康复干预的疗效。方法收集2016年9月至2017年8月山西省心血管病医院收治的行不完全血运重建术的不稳定型心绞痛患者100例作为研究对象,随机分为常规治疗组(50例)和康复干预组(50例),随访过程中2例失访,3例要求终止随访。最终纳入患者95例,其中常规治疗组47例,康复干预组48例。常规治疗组予常规出院指导,康复干预组在常规治疗基础上实施心脏康复干预。心脏康复干预措施包括运动处方、药物处方、营养处方、心理处方和戒烟处方等措施。分析不稳定型心绞痛患者不完全血运重建术后心脏康复干预的疗效。结果术后12个月,康复干预组血压达标率(79.2%比57.4%,P=0.023)、血糖达标率(87.5%比66.0%,P=0.013)、体重指数达标率(77.1%比55.3%,P=0.025)、总胆固醇达标率(83.3%比53.2%,P=0.002)、三酰甘油达标率(75.0%比46.8%,P=0.005)、低密度脂蛋白胆固醇达标率(79.2%比51.1%,P=0.004)、高密度脂蛋白胆固醇达标率(70.8%比48.9%,P=0.029)、峰值摄氧量[(21.27±1.79)ml/(kg·min)比(17.58±2.36)ml/(kg·min),P<0.001]、无氧阈[(16.86±2.43)ml/(kg·min)比(13.26±2.59)ml/(kg·min),P<0.001]、躯体功能[(82.90±3.96)分比(71.04±3.73)分,P<0.001]、躯体角色[(83.04±8.05)分比(67.57±6.04)分,P<0.001]、躯体疼痛[(77.81±9.60)分比(69.74±9.30)分,P<0.001]、精神健康[(84.44±6.22)分比(70.02±5.38)分,P<0.001]、精力[(73.02±8.83)分比(62.00±6.31)分,P<0.001]、社会功能[(78.46±6.30)分比(69.94±5.21)分,P<0.001]、情感职能[(76.27±8.87)分比(65.23±8.74)分,P<0.001]、总体健康[(79.63±9.28)分比(69.06±5.94)分,P<0.001]均高于常规治疗组,而吸烟率(10.4%比40.4%,P=0.001)、主要不良心血管事件发生率(6.3%比23.4%,P=0.022)及再住院率(4.2%比21.3%,P=0.014)显著低于常规治疗组,差异均有统计学意义。结论心脏康复干预可显著提高不稳定型心绞痛患者不完全血运重建术后危险因素控制达标率、运动耐量、生活质量,减少临床事件发生,显著改善患者预后。

关键词(KeyWords)： 心脏康复;不稳定型心绞痛;不完全血运重建;干预疗效

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 尉焱,安健,孔永梅,郝利军,刘盼盼

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