Abstract:

Objective　To observe the effect of exercise rehabilitation training under the guidance of precision medicine on the vascular endothelial function and prognosis in patients after intervention of arteriosclerosis obliterans (ASO). Methods　This was a prospective cohort study. A total of 123 ASO patients admitted to Nanyang First People's Hospital from January 2020 to March 2022 were selected as the study objects, and were divided into a routine group (61 cases) and a rehabilitation group (62 cases) by the random number table method. In the routine group, there were 33 males and 28 females, aged 45-75 (61.36±5.25) years. In the rehabilitation group, there were 32 males and 30 females, aged 43-77 (60.45±5.13) years. Routine rehabilitation exercise was performed in the routine group, and exercise rehabilitation training based on precision medicine was performed in the rehabilitation group. The enrolled patients were followed up for one year to compare their self-management ability, vascular endothelial function, and occurrence of related complications. t test and χ² test were used. Results　After intervention, the scores of Exercise of Self-care Agency Scale (ESCA) and General Self-Efficacy Scale (GSES) in the rehabilitation group [(125.44±20.61) points and (2.66±0.25) points] were higher than those in the routine group [(110.33±20.47) points and (1.92±0.61) points], with statistically significant differences (t=4.079 and 8.829, both P<0.001). At the end of follow-up, the flow mediated vasodilation (FMD) and nitroglycerin mediated vasodilation (NMD) [(12.25±3.14)% and (9.85±2.41)%] in the rehabilitation group were higher than those in the routine group [(10.11±3.47)% and (8.22±2.16)%], while the pulse wave velocity (PWV) [(10.24±3.45) m/s] was lower than that in the routine group [(12.41±3.12) m/s], with statistically significant differences (t=3.588, 3.948, and 3.657, all P<0.001). At the end of follow-up, the incidence of related complications in the rehabilitation group was 6.45% (4/62), which was lower than that in the routine group [18.03% (11/61)], with a statistically significant difference (χ²=6.242, P<0.05). Conclusions　The guidance of precision medicine can effectively improve the health cognition level in patients after ASO intervention and enhance their self-management ability. The exercise rehabilitation training based on precision medicine can promote the recovery of vascular endothelial function, and has a positive role in reducing the risk of related complications.

Key words:

Arteriosclerosis obliterans, Precision medicine, Exercise rehabilitation training, Vascular endothelial function, Prognosis

摘要：

目的　观察精准医学指导下的运动康复训练对动脉硬化闭塞症（ASO）介入术后患者血管内皮功能及预后的影响。方法　本文为前瞻性研究。选取2020年1月至2022年3月南阳市第一人民医院收治的123例ASO患者为研究对象，以随机数字表法分为常规组（61例）和康复组（62例）。常规组男33例、女28例，年龄45～75（61.36±5.25）岁，实施常规康复锻炼；康复组男32例、女30例，年龄43～77（60.45±5.13）岁，实施基于精准医学的运动康复训练，对入组患者开展为期1年随访。对比两组患者干预前后自我管理能力、血管内皮功能及相关并发症发生情况。采用t检验、χ²检验。结果　干预后，康复组自我护理能力量表（ESCA）、一般自我效能感量表（GSES）评分［（125.44±20.61）分、（2.66±0.25）分］均高于常规组［（110.33±20.47）分、（1.92±0.61）分］，差异均有统计学意义（t=4.079、8.829，均P<0.001）。随访结束时，康复组血流介导下管壁切应力引发的血管舒张功能（FMD）、硝酸甘油介导下管壁切应力引发的血管舒张功能（NMD）［（12.25±3.14）%、（9.85±2.41）%］均高于常规组［（10.11±3.47）%、（8.22±2.16）%］，脉搏波传导速度（PWV）［（10.24±3.45）m/s］低于常规组［（12.41±3.12）m/s］，差异均有统计学意义（t=3.588、3.948、3.657，均P<0.001）。随访结束时，康复组并发症发生率为6.45%（4/62），低于常规组［18.03%（11/61）］，差异有统计学意义（χ²=6.242，P<0.05）。结论　精准医学指导下的运动康复训练能有效改善ASO介入术后患者的健康认知水平，提升自我管理能力，促进患者血管内皮功能恢复，对降低相关并发症发生风险有积极作用。

关键词:

动脉硬化闭塞症, 精准医学, 运动康复训练, 血管内皮功能, 预后