Effect Of Rehabilitation Training On Cardiac Function And Exercise Endurance After Emergency PCI In Patients With Acute ST-segment Elevation Myocardial Infarction

With the rapid development of science and technology and the continuous improv With the rapid development of science and technology and the continuous improvement of living standards,high salt,high sugar,high fat diet and lack of exercise make the curve of statistics of chronic diseases in our country show a"J"rise.Coronary atherosclerotic heart disease(CHD)accounts for the highest proportion.Acute ST-Segment Elevation Myocardial Infarction(STEMI)is the highest mortality subtype of coronary heart disease.Percutaneous coronary intervention(PCI)can effectively reduce the death rate of STEMI.However,PCI can not reverse or delay the progression of atherosclerosis and atherosclerosis,nor can it eliminate the risk factors leading to CHD.Therefore,PCI is only a part of the STEMI treatment process,which is not enough to effectively improve the prognosis of patients.To effectively control the progress of disease in the long term depends on the health management of patients after PCI.Studies have shown that cardiac rehabilitation(CR)can reduce the risk factors of cardiovascular disease,delay the re-formation of atherosclerotic plaques,improve the quality of li fe of patients,and reduce the death rate and readmission rate of patients.The CR has been recommended for patients with coronary heart disease prevention of PCI postoperative? level and ? level.CR is a comprehensive and comprehensive intervention system.On the premise of good medical evaluation,patients were managed after PCI through five intervention methods,namely drug therapy,sports training,psychological counseling and health education(nutrition,smoking cessation).Among them,rehabilitation training,as the core of cardiac rehabilitation,has been reflected in the guidelines for the diagnosis and treatment of chronic heart failure at home and abroad,and has been used as the level IA or IB evidence for the treatment of heart failure.In this study,the effect of rehabilitation exercise training lasting for 6 months on poststemi PCI patients was observed under the premise of the same medical evaluation,medication,psychological counseling and health education.ObjectiveTo study whether 6-month rehabilitation training can improve the recovery of cardiac function and exercise endurance after emergency PCI in patients with acute ST-segment elevation myocardial infarction.MethodsSixty-five patients with acute ST-segment elevation myocardial infarction without serious complications after emergency PCI were selected from the Department of Cardiology,Affiliated Central Hospital of Shenyang Medical College from November 2017 to May 2018.All patients were divided into control group(32 cases)and experimental group(33 cases)according to random number table method.One in the control group lost the interview,one died,one in the experimental group lost the interview,and two quit because of lower limb fracture.Actual enrollment:30 cases in the control group and 30 cases in the experimental group.The two groups of patients all took the same four blocks for cardiac rehabilitation intervention,including drug treatment,psychological counseling,health education and regular follow-up.On this basis,patients in the experimental group were given rehabilitation training measures.The 2 groups received cardiac rehabilitation intervention for 6 months.The changes of each index in the two groups at admission and 6 months after PCI were monitored.Indicators include:the distance of 6-minute walk test(6MWT);Left ventricular ejection fraction(LVEF),left ventricular end diastolic inner diameter(LVDD),ventricular septal thickness(IVST),and left ventricular posterior wall thickness(LVPWT);As well as glycosylated hemoglobin(HbAlc),triglycerides(TG),total cholesterol(TC),high density lipoprotein(HDL-C)and low density lipoprotein(LDH-C).Results1.General data of two groups of patients were compared:The general data of sex,age,smoking,hypertension and diabetes in the control group were compared with those in the experimental group,the difference was not statistically significant(P>0.05).2.Comparison of indexes before intervention between two groups of patients:Compared with the control group and the experimental group at the time of entering the group,the test indexes(CHOL,TG,HDL-C,LDL-C,HbA1c),echocardiogram indexes(LVEF,LVDD,LVPWT,IVST)and 6MWT were not statistically significant(P>0.05).3.Comparison of indexes before and after intervention between two groups of patients:When the patients in the control group were selected,compared with the index of 6 months after PCI:6MWT,LDL-C,p<0.01;CHOL,TG,HDL-C,HbA1c,LVEF,P<0.05;the difference was statistically significant.LVDD,LVPWT,IVST,the difference was not statistically significant(P>0.05).When patients in the experimental group were enrolled,compared with the indicators 6 months after PCI,TG,HDL-c,LDL-c,HbA1c,LVEF,6MWT,P<0.01;CHOL,LVDD,P<0.05,the difference was statistically significant.LVPWT,IVST,P>0.05,the difference was not statistically significant.4.6 months after PCI,the experimental group was compared with the control group:6MWT,P<0.01,CHOL,TG,HDL-C,LDL-C,HbA1c,LVEF,P<0.05,the difference was statistically significant.LVDD,LVPWT,IVST,the difference was not statistically significant(P>0.05)ConclusionRehabilitation training has a positive effect on patients with acute st-segment elevation myocardial infarction after PCI,which strengthens the cardiac function and exercise endurance of patients,thus improving the quality of life of patients and effectively improving the prognosis of patients.