早期心脏康复在急性心肌梗死患者PCI术后阿司匹林治疗期间的应用效果OA
Application effect of early cardiac rehabilitation in acute myocardial infarction patients receiving aspirin after PCI
目的 探究早期心脏康复在治疗急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)后阿司匹林治疗期间的临床应用效果及其对康复质量的影响.方法 纳入 2023 年 10 月至 2025 年 10 月在苏州市立医院行 PCI 治疗的110 例 AMI 患者,根据患者实际接受的干预模式分为常规组和联合组,各 55 例.常规组给予阿司匹林治疗联合常规康复指导,联合组在此基础上实施早期心脏康复干预.比较2 组干预前后血流介导的血管舒张功能(FMD)、内皮素-1(ET-1)、血管紧张素Ⅱ(Ang-Ⅱ)、心肌酶谱指标[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、冠心病自我管理量表(CSMS)评分、运动耐量、Barthel 指数、6 分钟步行距离(6MWD)、躯体化症状自评量表(SSS)评分、中文版正性负性情绪量表(PANAS)评分[正性情绪(PA)、负性情绪(NA)]、凝血功能指标[凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)]、中国心血管病人生活质量评定问卷(CQQC)评分及主要不良心血管事件(MACEs)发生情况.结果 干预后,与常规组相比,联合组 FMD、CSMS 评分、运动耐量、Barthel 指数、PA 评分、PT、APTT、TT 水平及 CQQC 评分均升高,6MWD 延长,ET-1、Ang-Ⅱ、CK、CK-MB、LDH 及 FIB 水平、SSS、NA 评分及 MACEs 发生率均降低(P 均<0.05).结论 阿司匹林联合早期心脏康复干预可改善 AMI 患者 PCI 术后凝血功能、心肌酶谱、躯体化症状及负性情绪,提高自我管理能力和生活质量,并降低 MACEs 发生率,具有一定临床应用价值.
Objective To investigate the clinical efficacy of early cardiac rehabilitation in patients with acute myocardial infarction(AMI)receiving aspirin after percutaneous coronary intervention(PCI),and to evaluate its impact on the rehabilitation quality.Methods A total of 110 AMI patients who underwent PCI at Suzhou Municipal Hospital from October 2023 to October 2025 were included in the study.According to the intervention mode actually received,the patients were allocated into a conventional group and a combined group,with 55 cases in each group.The conventional group received aspirin combined with routine rehabilitation guidance,while the combined group received early cardiac rehabilitation intervention in addition to these measures of the conventional group.The two groups were compared before and after intervention regarding the following parameters:flow-mediated dilation(FMD),endothelin-1(ET-1),angiotensin Ⅱ(Ang-Ⅱ),myocardial enzyme spectrum markers(creatine kinase[CK],creatine kinase isoenzyme-MB[CK-MB],and lactate dehydrogenase[LDH]),Coronary Heart Disease Self-Management Scale(CSMS)score,exercise tolerance,Barthel Index,6-min walking distance(6MWD),Somatic Symptom Scale(SSS)score,Chinese version of the Positive and Negative Affect Schedule(PANAS)score(positive affect[PA]and negative affect[NA]),coagulation parameters(thrombin time[TT],activated partial thromboplastin time[APTT],prothrombin time[PT],and fibrinogen[FIB]),Chinese Questionnaire of Quality of Life in Patients with Cardiovascular Diseases(CQQC)score,and the incidence of major adverse cardiovascular events(MACEs).Results After intervention,compared with the conventional group,the combined group showed increases in FMD score,CSMS score,exercise tolerance,Barthel Index,PA score,PT,APTT and TT levels,CQQC score,and 6MWD(P<0.05).In addition,the combined group showed decreases in ET-1,Ang-Ⅱ,CK,CK-MB,LDH,FIB levels,SSS and NA scores,and incidence of MACEs(P<0.05).Conclusion The implementation of aspirin combined with early cardiac rehabilitation intervention can improve the coagulation function,myocardial enzyme spectrum,somatic symptoms,and negative emotions in AMI patients after PCI,enhance their self-management ability and quality of life,and reduce the incidence of MACEs.It shows certain clinical application value.
王丹丹;姚雪华
苏州市立医院,江苏 苏州,215000苏州市立医院,江苏 苏州,215000
医药卫生
阿司匹林早期心脏康复干预AMI患者PCI术后
aspirinearly cardiac rehabilitation interventionpatients with acute myocardial infarctionperiod after PCI
《中西医结合护理（中英文）》 2026 (6)
76-82,7
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