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目的:探讨曲美他嗪联合运动疗法对冠心病经皮冠状动脉介入(PCI)术后患者心脏康复作用的影响。方法:纳入冠心病PCI术后1个月内的患者90例,随机分成治疗A组、治疗B组及对照组,每组各30例。A组在冠心病二级预防治疗的基础上加用曲美他嗪并联合运动疗法、B组在冠心病二级预防治疗的基础上加用曲美他嗪、对照组仅给予冠心病二级预防治疗。观察期为6个月。监测3组患者的6 min步行试验(6MWT)的距离、6MWT时的心率及动脉血氧饱和度、左室舒张末期内径(LVEDD)、左室收缩末期内经(LVESD)、左室间隔厚度(LVIVS)、左心室后壁厚度(LVPWT)、左室射血分数(LVEF)及正常舒张功能的比例。结果:组内比较:与治疗前相比,3组的6MWT的距离明显增多、6MWT时的心率明显降低、正常舒张功能的比例明显升高并且LVEF明显增加,差异具有统计学意义(P<0.05)。治疗后组间比较:A组分别与B组及对照组相比,6MWT的距离明显增加、6MWT时的心率明显降低、正常舒张功能的比例明显升高且左室射血分数明显增加,差异具有统计学意义(P<0.017);B组与对照组相比,治疗后LVEF明显增加,差异具有统计学意义(P<0.017),6MWT的距离、6MWT时的心率及正常舒张功能的比例两组无明显改善(P>0.05)。结论:曲美他嗪联合运动疗法对冠心病PCI术后患者的心脏康复效果优于常规的冠心病二级预防治疗。
Objective: To investigate the effect of trimetazidine combined exercise therapy on cardiac rehabilitation in patients with coronary artery disease after percutaneous coronary intervention (PCI). Methods: 90 patients with coronary heart disease within 1 month after PCI were randomly divided into treatment A group, treatment B group and control group, 30 cases in each group. In group A, trimetazidine combined with exercise therapy was used on the basis of secondary prevention and treatment of coronary heart disease. Trimetazidine was added to group B on the basis of secondary prevention and treatment of coronary heart disease. Preventive treatment. Observation period of 6 months. The 6MWT distance, 6MWT heart rate and arterial oxygen saturation, left ventricular end diastolic dimension (LVEDD), left ventricular end-systolic (LVESD), left ventricular septal thickness (LVIVS ), Left ventricular posterior wall thickness (LVPWT), left ventricular ejection fraction (LVEF) and normal diastolic function. Results: Compared with before treatment, the distance of 6MWT in 3 groups was significantly increased, the heart rate was significantly decreased at 6MWT, the ratio of normal diastolic function was significantly increased and LVEF was significantly increased, the difference was statistically significant (P <0.05 ). After treatment, the comparison of group A: Compared with group B and control group, the distance of 6MWT increased significantly, the heart rate decreased significantly at 6MWT, the ratio of normal diastolic function increased significantly and the left ventricular ejection fraction increased significantly (P <0.017). Compared with the control group, the LVEF in group B was significantly increased after treatment (P <0.017), the distance of 6MWT, the heart rate at 6MWT and the proportion of normal diastolic function No significant improvement (P> 0.05). Conclusion: The effect of trimetazidine combined exercise therapy on cardiac rehabilitation in patients with coronary artery disease after PCI is superior to that of conventional secondary prevention of coronary heart disease.