牛亚芊芊,郭丹杰,邹尚志,金宗学,王岚,丁荣晶,郭琳,张天宏,韩春颖

• 1:北京大学人民医院心脏中心
• 2:内蒙古医科大学附属医院心血管内科

摘要(Abstract)：

目的比较急性期接受经皮冠状动脉介入治疗(PCI)完全或不完全血运重建的首次急性心肌梗死(AMI)患者运动耐量的差异。方法连续纳入2013年10月至2017年3月就诊于北京大学人民医院心脏中心并于急性期接受PCI的首次AMI患者112例,所有患者均于PCI后起始Ⅰ期康复,并于出院后完成心肺运动试验(CPET)。根据冠状动脉病变支数及血运重建程度分为三组:单支病变组(30例)、完全血运重建组(34例)以及不完全血运重建组(48例)。收集三组患者的一般资料情况、既往病史、用药情况、发病情况、入院情况、PCI情况以及术后CPET参数。比较三组患者Borg分级、峰值摄氧量(VO2peak)、无氧阈(AT)、代谢当量(MET)等运动耐量相关指标的差异。观察上述患者PCI后12个月内主要不良心血管事件(MACE),比较急性期接受PCI不同程度血运重建治疗的首次AMI患者MACE的差异。结果单支病变组、完全血运重建组、不完全血运重建组患者CPET分别达到Bruce分级3(1,4)级、3(1,5)级、3(1,4)级,三组患者比较差异无统计学意义(P=0.973)。三组患者Borg分级、AT时MET、峰值MET、AT时摄氧量、VO2peak及VO2peak%等比较,差异均无统计学意义(均P>0.05)。三组患者二氧化碳通气当量比较,差异有统计学意义(P=0.008);其中完全血运重建组[(31.2±4.9)比(30.9±2.9),P=0.0124]、不完全血运重建组[(34.6±4.9)比(30.9±2.9),P=0.0097]均显著高于单支病变组,差异均有统计学意义。三组患者均无心原性死亡发生,三组间MACE发生率比较,差异无统计学意义(P=0.483)。结论急性期PCI不完全血运重建的首次AMI患者的运动耐量并不逊于完全血运重建患者。

关键词(KeyWords)： 急性心肌梗死;完全性血运重建;不完全性血运重建;心肺运动试验;运动耐量

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 牛亚芊芊,郭丹杰,邹尚志,金宗学,王岚,丁荣晶,郭琳,张天宏,韩春颖

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