心脏康复策略对冠心病患者心肌酶谱及心室重塑的影响

Effect of cardiac rehabilitation strategy on myocardial enzymes and ventricular remodeling inpatients with coronary heart disease

  • 摘要:
      目的  探讨心脏康复策略对冠心病患者心肌酶谱及心室重塑的影响。
      方法  选择146例冠心病患者为研究对象,按照随机数表法将其随机分为对照组68例和康复组78例。对照组采用常规护理措施,康复组采用心脏康复策略。分析并比较2组患者的乳酸脱氢酶(LDH)、肌酸激酶(CK)、α-羟丁酸脱氢酶(HBDH)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)水平、心脏指数(CI)、心排血量(CO)、左心室射血分数(LVEF)以及心室重塑情况。
      结果  护理后,康复组LDH、CK、HBDH、CK-MB及AST水平显著低于对照组(P < 0.05); 护理前, 2组患者CI、CO、LVEF无显著差异(P>0.05), 护理后,康复组CI、CO、LVEF显著高于对照组(P < 0.05); 护理后,康复组心绞痛、心率失常、ST段改变以及梗死面积扩大的发生率显著低于对照组(P < 0.05)。
      结论  采用心脏康复策略对冠心病患者进行治疗,能够降低患者心肌酶谱指标水平,控制心室重塑的发展。

     

    Abstract:
      Objective  To explore the effect of cardiac rehabilitation strategy on myocardial enzymes and ventricular remodeling in patients with coronary heart disease.
      Methods  A total of 146 patients with coronary heart disease who were treated in our hospital were enrolled. According to the random number table method, the patients were randomly divided into control group(n=68) and rehabilitation group(n=78). The control group implemented routine nursing measures and the rehabilitation group implemented cardiac rehabilitation strategy. Lactate dehydrogenase (LDH), creatine kinase (CK), α-hydroxybutyrate dehydrogenase (HBDH), creatine kinase isoenzymes (CK-MB), glutamic-oxalacetic transamin (AST) levels, cardiac index (CI), cardiac output (CO), and left ventricular ejection fraction (LVEF) and ventricular remodeling were compared and analyzed.
      Results  After nursing, the levels of LDH, CK, HBDH, CK-MB and AST in the rehabilitation group were significantly lower than those in the control group (P < 0.05); before treatment, there were no significant differences in CI, CO and LVEF between the two groups(P>0.05); after nursing, the CI, CO and LVEF of the rehabilitation group were significantly higher than the control group(P < 0.05); after nursing, the incidence of angina pectoris, arrhythmia and ST segment changes, and expansion of infarct size in the rehabilitation group were significantly lower than that of the control group(P < 0.05).
      Conclusion  Cardiac rehabilitation strategy for patients with coronary heart disease can reduce myocardial enzyme levels and control the development of ventricular remodeling.

     

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