The Exercise Tolerance And Inflammatory Factor Changes In Patients With AMI And Cardiac Insufficiency After Rehabilitation Training

Objectives:Through to individualized treatment of rehabilitation training in patients with percutaneous coronary intervention(PCI)which have acute myocardial infarction(AMI)and cardiac insufficiency.To study the effect of rehabilitationtraining on AMI.Methods:To selection the patients with AMI and cardiac insufficiency suffer PCI.it can be divided into rehabilitation group and the control group.Rehabilitation group not only on the basis of the diet,psychological guidance,but also formulate individualized rehabilitation training according to the cardiac function classification and metabolic equivalents(METs),then control group didn't any exercise intervention.On 24h after PCI,1 month after discharged and 3 months after discharge,patients in rehabilitation group and control group testing the change about left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP),6 minutes walk test(6 MWT),cardiac function classification,activity,metabolic equivalents(METs),Borg score,IL-10,TNF alpha and leptin.Results:(1)LVEF(%):The control group patients on 3 months after discharge is better then within 24 hours(P<0.05);and on 3 months after discharge is better then 1 month after discharge(P<0.05);The rehabilitation group patients on 1 months after discharge is better then within 24 hours(P<0.05);and on 3 months after discharge is better then 1 month after discharge(P<0.05);The rehabilitation group patients on 1 months after discharge and 3 months after discharge is better then the control group to the corresponds time(P<0.05);(2)6 MWT:The control group patients on 3 months after discharge is longer then then 1 month after discharge(P<0.05);The rehabilitation group patients on 1 months after discharge is longer then within 24 hours(P<0.05);and on 3 months after discharge is longer then 1 month after discharge(P<0.05);The rehabilitation group patients on 1 months after discharge and 3 months after discharge is longer then the control group to the corresponds time(P<0.05);(3)BNP:The control group patients on 1 months after discharge is less then within 24 hours(P<0.05);and on 3 months after discharge is iess then 1 month after discharge(P<0.05);The rehabilitation group patients on 1 months after discharge andl months after discharge is less less then within 24 hours(P<0.01);The rehabilitation group patients on 1 months after discharge and 3 months after discharge is less then the control group to the corresponds time(P<0.05);(4)The improve ratio of cardiac function classificationas in rehabilitation group is better then the control group(P<0.05),and the incidence rate of angina pectoris in rehabilitation group is reduction than control group;(5)The rise ratio of exercise METs in rehabilitation group is better then the control group(P<0.05);(6)The Borg score in rehabilitation group is lower then the control group(P<0.05),movement difficulty become ease;(7)Rehabilitation group of IL-10,the TNF alpha and LEP:There is significant difference between 1 month after discharge and within 24 houes(P<0.05),there is significant difference between l month after discharge and 3 month after discharge(P<0.05);(8)The control group:IL-10:there is significant difference between 3 month after discharge and within 24 houes(P<0.05),TNF alpha and LEP:there is significant difference between 1 month after discharge and within 24 houes(P<0.05),there is significant difference between 1 month after discharge and 3 month after discharge(P<0.05);(9)Rehabilitation group compared with control group:IL-10:there is no significant difference on 1 month after discharge(P>0.05),there is significant difference on 3 month after discharge(P<0.05);TNF alpha:there is significant difference on 1 month after discharge(P<0.05),there is significant difference on 3 month after discharge(P<0.05);LEP:there is significant difference on 1 month after discharge(P<0.05),there is significant difference on 3 month after discharge(P<0.05).Conclusions:(1)Rehabilitation treatment can improve heart function better;(2)Rehabilitation treatment can decrease the degree of heart failure;(3)Rehabilitation treatment can reduce postoperative angina pectoris in patients with PCI Which have acute myocardial infarction(AMI)and cardiac insufficiency;(4)The treatment of rehabilitation training can improve exercise tolerance;(5)Rehabilitation training can improve the inflammatory response of AMI;(6)IL-10,the TNF alpha and leptin involved in inflammatory.reactionin on patients with PCI which have AMI and cardiac insufficiency.