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目的:研究基于运动负荷试验评估的个性化有氧运动对急性心肌梗死(AMI)患者心功能与心理状态的疗效。方法:选择80例恢复期的AMI患者为研究对象,采用随机数字表法,患者被均分为常规治疗组(40例,接受常规药物治疗)和运动组(40例,在常规治疗组基础上接受基于运动负荷试验评估的个性化有氧运动)。比较两组患者干预前、干预12周后的血清高敏心肌肌钙蛋白I(hs-cTnI)和肌酸激酶同工酶(CK-MB)水平,左室射血分数(LVEF)、每博量(SV)、左室短轴缩短率(LVFS)、室壁增厚率(△T)、室间隔运动幅度(AIS),以及焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。结果:与干预前比较,干预12周后两组的血清hs-cTnI和CKMB水平均明显降低,SAS和SDS评分亦均显著降低;LVEF,SV,LVFS,△T和AIS均显著升高(常规治疗组的LVEF除外),P<0.05或<0.01;且与常规治疗组比较,运动组血清hs-cTnI[(9.31±1.04)ng/L比(5.89±0.72)ng/L]和CK-MB水平[(11.34±1.25)U/L比(8.41±1.01)U/L];SAS[(51.34±6.54)分比(42.32±5.29)分]和SDS[(50.23±6.92)分比(43.86±6.03)分]评分降低更显著,LVEF[(57.12±6.67)%比(62.32±7.34)%],SV[(62.45±7.13)ml比(69.18±7.84)ml],LVFS[(23.93±2.96)%比(28.45±3.12)%],△T[(28.51±3.41)%比(34.52±4.87)%]和AIS[(9.56±1.02)mm比(12.45±1.46)mm]升高更显著,P<0.05或<0.01。结论:基于运动负荷试验评估的个性化有氧运动能够减轻心肌细胞损伤、改善心脏功能、缓解负面情绪,促进患者迅速康复。
AIM: To investigate the effect of personalized aerobic exercise on cardiac function and psychological status in patients with acute myocardial infarction (AMI) based on the assessment of exercise stress. Methods: Eighty patients with AMI during convalescence were enrolled in this study. Patients were divided into routine treatment group (n = 40) and exercise group (n = 40), based on the conventional treatment group Accept personalized aerobic exercise based on assessment of exercise load). The levels of serum hs-cTnI and CK-MB, LVEF, (SV), LVFS, △ T, and AIS were measured, as well as SAS and SDS, score. Results: Compared with those before intervention, serum hs-cTnI and CKMB levels were significantly decreased and SAS and SDS scores were significantly decreased in both groups after 12 weeks of intervention; LVEF, SV, LVFS, △ T and AIS were significantly increased (9.31 ± 1.04) ng / L (5.89 ± 0.72) ng / L] and CK-MB in the exercise group were significantly higher than those in the normal treatment group (P <0.05 or <0.01) (11.34 ± 1.25) U / L ratio (8.41 ± 1.01) U / L]; SAS [(51.34 ± 6.54) vs 42.32 ± 5.29] and SDS [(50.23 ± 6.92) 6.023), the LVEF [(57.12 ± 6.67)% vs (62.32 ± 7.34)%], SV [(62.45 ± 7.13) ml vs 69.18 ± 7.84 ml], LVFS [(23.93 ± 2.96) (28.45 ± 3.12)%], △ T (28.51 ± 3.41)% (34.52 ± 4.87)% and AIS (9.56 ± 1.02) mm (12.45 ± 1.46) mm, P <0.05 or <0.01. CONCLUSION: Personalized aerobic exercise based on assessment of exercise load can reduce cardiomyocyte injury, improve cardiac function, relieve negative emotion and promote rapid recovery.