运动康复治疗对合并抑郁的急性心肌梗死患者心功能、生活质量及近期预后的影响

摘要

Objective:To explore the effects of exercise rehabilitation on cardiac function,quality of life (QOL) and short-term prognosis in patients with acute myocardial infarction(AMI)and depression.Methods:The patients with AMI were recruited,divided into non-depression group (group A)and depression group (group B)according to the Depression Scale score,and in each group,patients were also divided into conventional drug treatment group (group A1 and group B1)and conventional drug therapy combined with exercise rehabilitation group (group A2 and group B2).Cardiac function,life quality and short-term prognosis were evaluated.Results:There was no statisti-cally significant difference among four groups in all measurements at the baseline (P>0.05).After treatment for 8 weeks,the cardiac function and QOL were significantly improved (P<0.05)in groups A2 and B2 compared to groups A1 and B1.As compared with group B2,the cardiac function and QOL in group A2 were improved (P<0.05).After treatment for 8 weeks,the incidence of heart failure and cardiogenic shock had statistically significant differences,and the results were:A20.05).Conclusion:The incidence of heart failure and cardiogenic shock was higher in the AMI patients with depres-sion than in the patients without depression.The exercise rehabilitation could reduce the incidence of heart failure and cardiogenic shock in the AMI patients with or without depression;Exercise rehabilitation could improve the QOL and heart function in the AMI patients with or without depression.Compared to the AMI patients with depres-sion,exercise rehabilitation were more effective in the QOL and cardiac function in the AMI patients without depres-sion.%目的:运动康复治疗对合并抑郁的急性心肌梗死患者心功能、生活质量及近期预后的影响.方法:选择我院心内科接受治疗的急性心肌梗死患者为研究对象.依据抑郁量表评分分为无抑郁组(A 组)和抑郁组(B组),两组各分为常规药物治疗组(A1组和B1组)和常规药物治疗联合运动康复治疗组(A2组和B2组)各60例.对比各组患者心功能及生活质量的改善情况及近期预后.结果:4组患者治疗前生活质量及心功能无统计学差异,治疗8周后 A2组患者比 A1组、B2组比B1组患者心功能明显改善,生活质量明显提高(均P<0.05);且 A2与 B2组相比,心功能及生活质量改善更明显,差异具有统计学意义(均P<0.05).8周后患者心力衰竭、心源性休克发生率, A2组0.05).结论:抑郁组患者心力衰竭及心源性休克的发生率较无抑郁组高;无论患者是否合并抑郁,运动康复治疗均可减少心力衰竭及心源性休克的发生率;无论患者是否合并抑郁,运动康复治疗均可以改善患者的生活质量及心功能,但是无抑郁组患者改善更明显.