康复治疗对重症冠状动脉搭桥术后患者血浆脑钠肽水平的影响

关键词：冠状动脉搭桥术  康复  脑钠肽

Keywords:coronary artery bypass graft  rehabilitation  brain natriuretic peptide

摘要：

      目的：观察康复治疗对冠状动脉搭桥术后患者血浆脑钠肽水平的影响。方法：随机对照研究将46例拟行冠状动脉搭桥的住院患者分为康复组（n=25）和对照组(n=21)，康复组给予逐渐递增的康复运动治疗。对血浆脑钠肽、左室射血分数、6min步行距离和术后平均住院时间进行观察。结果：与对照组相比，康复组患者的脑钠肽水平明显下降（P＜0.05），左室射血分数改善（P＜0.05）。而且，康复组患者6min步行距离明显长于对照组（P＜0.01），康复组患者术后平均住院时间也明显缩短（P＜0.01）。康复组患者的上述观察指标相关性分析显示脑钠肽分别与左室射血分数(r=-0.66,P＜0.01）和6min步行距离(r=-0.52,P＜0.01）成负相关。结论：康复治疗可以提高冠脉搭桥术后患者的运动能力，加速脑钠肽水平的降低，促进心脏功能的恢复。

Abstract:

      Objective:To observe the effects of rehabilitation for patients after severe coronary artery bypass grafting on the brain natriuretic peptide(BNP) levels. Method: This randomized prospective study included 46 patients undergoing coronary artery bypass grafting and the patients were allocated to one of two groups: cardiac rehabilitation group(rehab; n=25， patients received gradually increasing rehabilitation exercises intervention), and usual care group(control; n=21).The plasma levels of BNP，left ventricular ejection fraction, 6-min walk distance and post-operative length of stay(PLOS) were measured. Result: Compared with control group，BNP level in rehab group descended significantly（P＜0.05） and left ventricular ejection fraction improved（P＜0.05）.Furthermore rehab patient′s 6-min walk distance was significantly longer than control group(P<0.01). The length of in-hospital stay after surgery reduced in rehab group(P<0.01). The rehab group showed a negative correlation between BNP level and left ventricular ejection fraction(r=-0.66,P＜0.01）and 6-min walk distance(r=-0.52,P＜0.01），respectively. Conclusion: Rehabilitation exercises in patients after coronary artery bypass grafting may improve exercises capacity of patients, reduce BNP and improve heart function.