康复学报2026，Vol.36Issue(1)：46-55,10.DOI:10.3724/SP.J.1329.2026.01007
基于加速康复外科探讨新型心脏康复训练对急性心肌梗死经皮冠状动脉介入术后患者心功能的影响
Effect of Novel Cardiac Rehabilitation Training on Cardiac Function in Patients with Acute Myocardial Infarction after PCI Based on Enhanced Recovery After Surgery
摘要
Abstract
Objective To investigate the effect of novel cardiac rehabilitation training on cardiac function in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)based on enhanced recovery after surgery(ERAS).Methods A total of 92 AMI patients admitted to the cardiology department of Dongying District People's Hospital from May 2020 to May 2023 were selected and randomly divided into control group and experimental group using a random number table method,with 46 patients in each group.Both groups received standardized symptomatic treatment and PCI surgery after admission.The control group received routine cardiac rehabilitation training in addition to the standardized treatment.On the basis of standard-ized treatment and routine cardiac rehabilitation training,the experimental group was given a new type of cardiac rehabilitation train-ing based on ERAS.Peak power(PP),left ventricular end-systolic diameter(LVESD),and left ventricular ejection fraction(LVEF)were measured using a color echocardiography diagnostic instrument before training,after one month of training,and after three months of training;Cardiopulmonary Exercise Testing were used to assess exercise endurance,including exercise duration(ED),peak oxygen uptake(VO2),and anaerobic threshold(AT);N-terminal pro-brain natriuretic peptide(NT-proBNP)was measured using the Roche Cobas e411 chemiluminescence analyzer;superoxide dismutase(SOD)activity was measured using the xanthine oxidase method;malondialdehyde(MDA)expression level was measured using the thiobarbituric acid colorimetric method;total antioxi-dant capacity(T-AOC)was measured using the phenanthrene colorimetric method;expression levels of interleukin-18(IL-18),nu-cleotide-binding oligomerization NOD-like receptor protein 3(NLRP3),and interleukin-1β(IL-1β)were measured using the en-zyme-linked immunosorbent assay,and expression level of nuclear factor kappa B(NF-κB)was measured using the enzyme-linked immunosorbent assay.Cardiopulmonary function was evaluated with the 6-Minute Walk Test(6MWT).The Myocardial Infarction Dimensional Assessment Scale(MIDAS)was used to evaluate the patients'quality of life.Results Compared with those before training,PP and LVEF increased in both groups after one month and three months of training(P<0.05),while LVESD and NT-proB-NP expression levels decreased(P<0.05);compared with those after one month of training,PP and LVEF increased in both groups after three months of training(P<0.05),while LVESD and NT-proBNP expression levels decreased(P<0.05);compared with those in the control group at the same time,the experimental group showed an increase in PP and LVEF after one month and three months of training(P<0.05),while the expression levels of LVESD and NT-proBNP decreased(P<0.05).Compared with those before train-ing,both groups showed an increase in VO2 peak and AT values after 1 month and 3 months of training(P<0.05),and an extension of ED(P<0.05);compared with one month after training,both groups showed an increase in VO2 peak and AT values(P<0.05)and a prolongation of ED(P<0.05)after three months of training;compared with those in the control group at the same time,the experi-mental group showed an increase in VO2 peak and AT value after one month and three months of training(P<0.05),and an ex-tension of ED(P<0.05).Compared with before training,SOD activity and T-AOC increased(P<0.05)and MDA expression level decreased(P<0.05)in both groups after one month and three months of training;compared with one month after training,both groups showed an increase in SOD activity and T-AOC after three months of training(P<0.05),while MDA expression level de-creased(P<0.05);compared with those in the control group at the same time,the experimental group showed an increase in SOD activity and T-AOC(P<0.05)and a decrease in MDA expression level(P<0.05)after one month and three months of training.Com-pared with before those training,the expression levels of IL-18,IL-1β,NF-κB,and NLRP3 decreased in both groups after one month and three months of training(P<0.05);compared with one month after training,the expression levels of IL-18,IL-1β,NF-κB,and NLRP3 decreased in both groups after three months of training(P<0.05);compared with those in control group at the same time,the expression levels of IL-18,IL-1β,NF-κB,and NLRP3 decreased in the experimental group after one month and three months of training.Compared with before those training,both groups showed an increase in 6MWT after one month and three months of training(P<0.05),and a decrease in MIDAS score(P<0.05);compared with one month after training,both groups showed an increase in 6MWT(P<0.05)and a decrease in MIDAS score(P<0.05)after three months of training;compared with those in the control group at the same time,the experimental group showed an increase in 6MWT and a decrease in MIDAS score after one and three months of training(P<0.05).Conclusion The novel ERAS-based cardiac rehabilitation training can regulate heart failure markers,antioxidant capacity,and inflammation levels in AMI patients after PCI,which helps improve cardiac function,enhance exercise endurance,and reduce the risk of adverse cardiac events.关键词
急性心肌梗死/加速康复外科/心脏康复训练/经皮冠状动脉介入术/心功能/运动耐力Key words
acute myocardial infarction/enhanced recovery after surgery/cardiac rehabilitation training/percutaneous coro-nary intervention/cardiac function/exercise endurance引用本文复制引用
成媛媛,周同同,李楠楠,宋晓丽..基于加速康复外科探讨新型心脏康复训练对急性心肌梗死经皮冠状动脉介入术后患者心功能的影响[J].康复学报,2026,36(1):46-55,10.基金项目
山东省中医药科技项目(202303071519) （202303071519）
