Abstract:

Objective　To observe the effects of cardiac rehabilitation treatment on endothelin-1 level and cardiac function in patients with heart disease after percutaneous coronary intervention (PCI). Methods　A total of 77 patients with heart disease after PCI admitted to Zhumadian Central Hospital from March 2022 to October 2023 were prospectively selected as the study objects and were divided into a control group (38 cases) and an observation group (39 cases) by the random number table method. In the control group, there were 22 males and 16 females, aged 43-69 (57.71±5.28) years, and the course of disease was 1-7 (3.76±1.25) years. In the observation group, there were 24 males and 15 females, aged 44-70 (58.12±5.32) years, and the course of disease was 1-8 (3.82±1.31) years. The control group received conventional treatment, and the observation group received cardiac rehabilitation therapy on the basis of the control group. Both groups were treated for 3 months. The mastery of cardiac rehabilitation (cardiac rehabilitation cognition survey scale), self-management ability [Coronary Heart Disease Self-Management Behavior Scale (CSMS)], exercise endurance (6 min walking distance), vascular endothelial function (endothelin-1, von Willebrand factor, and endothelium-dependent diastolic function), cardiac function (left ventricular ejection fraction, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and cardiac output), and quality of life (SF-36) were compared between the two groups before and after treatment. Independent sample t test, paired t test, and χ² test were used. Results　After treatment, the mastery of cardiac rehabilitation [(60.72±2.96) points], self-management ability [(82.98±3.79) points], and exercise endurance [(496.88±27.34) m] of the observation group were better than those of the control group [(55.49±3.45) points, (78.39±4.22) points, and (451.69±35.45) m] (all P<0.05). After treatment, the levels of endothelin-1 [(3.79±0.51) ng/L] and von Willebrand factor [(219.64±29.15)%] in the observation group were higher than those in the control group [(3.12±0.45) ng/L and (197.89±28.46)%], and the level of endothelium-dependent diastolic function [(5.15±0.43)%] was lower than that in the control group [(5.97±0.62)%] (all P<0.05). After treatment, the left ventricular ejection fraction [(64.96±1.26)%] and cardiac output [(6.13±0.45) min/L] in the observation group were higher than those in the control group [(61.99±1.31)% and (5.77±0.65) min/L], and the left ventricular end-systolic diameter [(37.79±1.37) mm] and left ventricular end-diastolic diameter [(41.65±1.28) mm] were shorter than those in the control group [(39.35±1.24) mm and (48.43±1.42) mm] (all P<0.05). After treatment, the scores of 8 dimensions of life quality of the observation group were higher than those of the control group (all P<0.05). Conclusions　Cardiac rehabilitation therapy has a definite effect on the treatment of heart disease patients after PCI, which can effectively improve the patients' vascular endothelial function and cardiac function, improve their quality of life, and facilitate their prognosis. It can be clinically applied and promoted.

Key words:

Percutaneous coronary intervention, Heart disease, Cardiac rehabilitation therapy, Endothelin-1, Cardiac function

摘要：

目的　观察心脏疾病患者经皮冠状动脉介入（PCI）术后行心脏康复治疗对其内皮素-1水平和心功能的影响。方法　前瞻性选取2022年3月至2023年10月驻马店市中心医院收治的77例PCI术后心脏疾病患者作为研究对象。采用随机数字表法，将患者分为对照组（38例）和观察组（39例）。对照组男22例，女16例；年龄43～69（57.71±5.28）岁；病程1～7（3.76±1.25）年。观察组男24例，女15例；年龄44～70（58.12±5.32）岁；病程1～8（3.82±1.31）年。对照组采用常规治疗，观察组在对照组基础上采用心脏康复疗法。两组均治疗3个月。比较两组治疗前后心脏康复的掌握程度（心脏康复认知调查量表）、自我管理能力［冠心病自我管理行为量表（CSMS）］、运动耐力（6 min行走试验）、血管内皮功能（内皮素-1、血管性血友病因子、内皮依赖性舒张功能）、心功能（左心室射血分数、左心室收缩末期内径、左心室舒张末期内径、心输出量）、生活质量［简明健康状况量表（SF-36）］。采用独立样本t检验、配对t检验和χ²检验。结果　治疗后，观察组心脏康复的掌握程度［（60.72±2.96）分］、自我管理能力［（82.98±3.79）分］、运动耐力［（496.88±27.34）m］均优于对照组［（55.49±3.45）分、（78.39±4.22）分、（451.69±35.45）m］（均P<0.05）；观察组内皮素-1［（3.79±0.51）ng/L］与血管性血友病因子［（219.64±29.15）%］水平均高于对照组［（3.12±0.45）ng/L、（197.89±28.46）%］，内皮依赖性舒张功能［（5.15±0.43）%］水平低于对照组［（5.97±0.62）%］（均P<0.05）；观察组左心室射血分数［（64.96±1.26）%］与心输出量［（6.13±0.45）L/min］均高于对照组［（61.99±1.31）%、（5.77±0.65）L/min］，左心室收缩末期内径［（37.79±1.37）mm］、左心室舒张末期内径［（41.65±1.28）mm］均短于对照组［（39.35±1.24）mm、（48.43±1.42）mm］（均P<0.05）；观察组生活质量评分（8个维度）均高于对照组（均P<0.05）。结论　心脏康复治疗在PCI术后心脏疾病患者中疗效确切，可有效改善患者血管内皮功能与心功能，提高生活质量。

关键词:

经皮冠状动脉介入术, 心脏疾病, 心脏康复治疗, 内皮素-1, 心功能