李含蓄 孙锋

【摘要】 目的：探討心脏康复训练联合硝酸异山梨酯对中老年冠心病患者PCI术后心功能、运动耐力和生活质量的影响。方法：选取2018年10月-2019年12月在本院就诊的70例冠心病PCI术后患者，按随机数字表法分为对照组（n=35）及观察组（n=35）。对照组患者在术后常规治疗基础上加用硝酸异山梨酯，观察组在对照组基础上进行心脏康复训练。比较两组患者左室射血分数、左室舒张内径、BNP水平、6 min步行距离、明尼苏达心力衰竭生活质量评分、中医证候积分及心血管因素死亡发生情况。结果：观察组患者左室射血分数、6 min步行距离高于对照组（P<0.05）;左室舒张内径、BNP水平、明尼苏达心力衰竭生活质量评分及中医证候积分均低于对照组（P<0.05）。结论：心脏康复训练联合硝酸异山梨酯在冠心病PCI术后的疗效优于单纯常规治疗，可改善患者症状、心功能、运动耐力，生活质量明显提升，适合临床上选择应用。

【关键词】 心脏康复训练 硝酸异山梨酯 冠心病 PCI术后 心功能 运动耐力 生活质量

Effects of Cardiac Rehabilitation Training Combined with Isosorbide Dinitrate on Cardiac Function， Exercise Endurance and Quality of Life in Elderly Patients with Coronary Heart Disease after PCI/LI Hanxu， SUN Feng. //Medical Innovation of China， 2021， 18（13）： 0-102

[Abstract] Objective： To investigate the effects of cardiac rehabilitation training combined with Isosorbide Dinitrate on cardiac function， exercise endurance and quality of life in elderly patients with coronary heart disease after PCI. Method： A total of 70 patients with coronary heart disease after PCI who visited our hospital from October 2018 to December 2019 were selected， and they were divided into control group （n=35） and observation group （n=35） according to the random number table method. Patients in the control group were treated with Isosorbide Dinitrate on the basis of conventional postoperative treatment， and the observation group received cardiac rehabilitation training on the basis of the control group. Left ventricular ejection fraction， left ventricular diastolic diameter， BNP level， 6 min walking distance， Minnesota quality of life for heart failure scores， TCM syndrome score and incidence of death from cardiovascular factors of two groups were compared. Result： The left ventricular ejection fraction and 6 min walking distance in the observation group were higher than those of the control group （P<0.05）. Left ventricular diastolic diameter， BNP level， Minnesota quality of life for heart failure scores and TCM syndrome scores were lower than those of the control group （P<0.05）. Conclusion： Cardiac rehabilitation training combined with Isosorbide Dinitrate in coronary heart disease after PCI has better efficacy than conventional treatment alone， it can improve the symptoms， cardiac function， exercise endurance of patients， significantly improve the quality of life， suitable for clinical application.

[Key words] Cardiac rehabilitation training Isosorbide Dinitrate Coronary heart disease After PCI Cardiac function Exercise endurance Quality of life

First-authors address： Tenth Peoples Hospital of Shenyang City， Shenyang 110044， China

doi：10.3969/j.issn.1674-4985.2021.13.024

冠心病是由冠状动脉硬化引起的管腔内壁狭窄或痉挛，导致心脏净血流量减少，而引发心肌缺氧缺血的一类基础疾病[1]。其死亡率始终高居不下，且仍有增长趋势，尤其对于中老年患者而言，若无针对性的治疗干预，冠心病死亡风险会成倍增加，成为危害中老年生命健康的顽固性疾病[2]。经皮冠状动脉介入术（PCI）逐渐的兴起与发展为冠心病患者带来福音，已成为狭窄管腔再灌注最有效、最直观治疗手段[3]。随着PCI技术成熟，人们对其接受程度骤升，但针对PCI术后所出现的问题依然存在，例如术后再狭窄、再灌注受损等，有增加心脏负荷，影响心功能，继发心衰的风险[4]。因中老年患者基础疾病众多，PCI术后继发功能障碍的风险更高，故如何防范PCI术后心功能下降已成为如今临床中所面对的主要问题[5]。……