運動療法可縮短急性心肌梗塞患者運動耐受力之自然恢復療程與改善血液動力變化

目的：增進心肺功能與改善不適症狀可提高患者生活品質及自信心，進而促使早日重返工作崗位。本研究在探討性心肌梗塞後，患者之運動耐受力自然恢復過程中，第二期外來式監視型運動療法（運動療法）之角色以及運動療法對患者血液動力變化之長短期影響。病人與方法：本研究以急性心肌梗塞患者為對象，依接受運動療法有無，分成實驗組（男：14位、女：1位）與控制組（男：8位、女：2位）。實驗組是以目標心跳數做為運動療法時之運動訓練強度依據，從急性心肌梗塞後第18±4日起每週二次持續八週。以極限症候限制（maximal symptom-limited）時的METs（metabolic equivalents）值（最大METs值）作為運動耐受力（exercise capacity）指標；以心跳數與收縮壓作為血液動力參數指標。運動測試是分別於運動療法前（第一次）、後（第二次）、後三個月（第三次）實施。結果：相較於控制組之最大METs之顯著增加需至第三次運動測試時（6.8±1.4 vs 9.2±1.0 METs, p=0.002），以及第二次最大METs值時的心跳數、收縮壓亦隨最大METs值之增加而顯著增加；實驗組第二次運動測試時的心跳數以及收縮壓無顯著變化下，最METs值已呈顯著增加，但其中只有最大METs值可持續到第三次運動測試時（6.5±1.4 vs 10.0±1.7;9.8±1.5 METs, p=0.000）。結論：本研究顯示運動療法可縮短運動耐受力之自然恢復療程，對血液動力參數指標心跳數、收縮壓有其短期療效。

關鍵字

急性心肌梗塞；運動療法；自然恢復療程；運動耐受力；血液動力參數

並列摘要

Objective: To evaluate the effects of a supervised, hospital-based phase II cardiac exercise therapy program (exercise therapy) on the natural recovery course of exercise capacity (METs: metabolic equivalents) and on the exercise heomdynamic responses in patients with acute myocardial infarction (AMI). Patients and Methods: We compared the exercise capacity and hemodynamic response changes between patients those who participated in exercise therapy (n=15) and those who did not (n=10). Exercise therapy began on the (18±4)th day after AMI and continued for eight weeks at a frequency of two times per week. Exercise tests were performed pre-, post- and three months after the exercise therapy program. Results: In exercise group, exercise therapy increased exercise capacity significantly and these effects continued to the third month after exercise therapy (6.5±1.4 METs vs 10.0±1.7 METs, 9.8±1.5 METs respectively, p=0.000). The control group had significant exercise capacity increases three months after exercise therapy at the same level as those in exercise group. There were no significant changes in exercise hemodynamic responses between pre- and post- exercise therapy in exercise group. The exercise hemodynamic responses of exercise group, however, were the same as those of control group three months after exercise therapy. Conclusions: This study revealed that exercise therapy may shorten the natural recovery course of exercise capacity in patients after AMI, but its effects on the stabilization of exercise hemodynamic responses are short-term. Thus, long-term effective exercise therapy is necessary for patients after AMI to improve their quality of life and prevent repeat infarction.

並列關鍵字

acute myocardial infarction ； exercise therapy ； exercise capacity ； natural recovery course ； hemodybamic response

被引用紀錄

蔡月娥（2009）。冠狀動脈疾患對出院準備服務之成效及其滿意度探討〔碩士論文，中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834/CSMU.2009.00071

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運動療法可縮短急性心肌梗塞患者運動耐受力之自然恢復療程與改善血液動力變化

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