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目的探讨早期康复训练对急性心肌梗死(AMI)患者病情的影响。方法将122例急性心肌梗死低危患者平行随机分为康复组(62例)和对照组(60例)。两组除予以临床常规治疗外,康复组采用为期2周以步行为主的康复训练。结果两组患者在室性心律失常(Lown≥Ⅲ级)、梗死延展的发生率和心率变异性(HRV)测定等方面,差异无统计学意义(P＞0．05)。入院第3～4周康复组左心室射血分数(LVEF)≥150%者的比例为64．5%(40/62),显著高于对照组的45．0%(27/ 60,P＜0．01)。第4周末的平板运动试验阳性率,康复组显著低于对照组(25．8%比38．3%,P＜0．01)。康复组住院期间心绞痛、再梗死和死亡率均低于对照组。康复组平均住院天数为(16±3) d,对照组为(27±4)d,两组差异有统计学意义(P＜0．05)。结论对无明显并发症的AMI患者采取早期康复训练是安全可行的,有利于促进患者病情恢复,提高生存质量。
Objective To investigate the effect of early rehabilitation training on the patients with acute myocardial infarction (AMI). Methods 122 patients with acute myocardial infarction were randomly divided into rehabilitation group (62 cases) and control group (60 cases). In addition to the two groups were routine clinical treatment, the rehabilitation group used a 2-week walk-based rehabilitation training. Results There was no significant difference in ventricular arrhythmia (Lown≥Ⅲlevel), incidence of infarction extension and heart rate variability (HRV) between the two groups (P> 0.05). The proportion of left ventricular ejection fraction (LVEF) ≥150% in rehabilitation group from the 3rd to 4th week after admission was 64.5% (40/62), significantly higher than that in the control group (45.0%, 27/60, P < 0.01). The positive rate of treadmill exercise test on the 4th weekend was significantly lower in the rehabilitation group than in the control group (25.8% vs 38.3%, P <0.01). During the hospitalization, angina, re-infarction and mortality in the rehabilitation group were lower than those in the control group. The average length of stay in rehabilitation group was (16 ± 3) days, and in control group (27 ± 4 days), the difference was statistically significant (P <0.05). Conclusion It is safe and feasible to take early rehabilitation training for patients with AMI without obvious complication, which is beneficial to promote the recovery of patients and improve the quality of life.