[预测急性心肌梗死冠状动脉支架植入术患者的康复治疗效果:关注康复潜力]。

S G Abramovich, O O Knyazyuk, I M Mikhalevich, E A Shchedreeva
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引用次数: 0

摘要

寻找评估急性心肌梗死(AMI)患者接受支架植入术的康复潜力(RP)的方法仍然具有相关性,这将允许个性化方法为特定患者开出必要的治疗组合,提高其有效性并减少并发症的可能性。目的:建立一种评价急性期心肌梗死患者RP的方法,并评价其对早期恢复期治疗措施有效性的预测作用。材料与方法:本研究分为两部分。在第一部分中,采用数学建模的方法建立了AMI患者RP的评估方法。为此,我们对137例(训练样本)AMI患者(年龄34 ~ 85岁,平均年龄59.4±2.1岁)的出院史进行分析。在研究的第二部分,对这些患者进行康复措施的结果进行分析,这些患者在重症监护室和重症监护室之后转到安加拉临床度假村JSC的心内科。在康复II期结束时,一个多学科团队使用表征急性冠状动脉综合征和支架植入术患者临床状况的综合指标评估了患者治疗的有效性。结果:研究的第一部分致力于建立AMI患者RP评估的数学模型,创建了方法学算法:形成形式化的患者图,证据库由109个指标表示;某些指标被赋予线性分类函数的系数值,根据该指标,患者可分为三组:1组-高RP;2组-中RP;组3 -低RP。研究的第二部分致力于确定RP在早期康复期(医学康复II期)预测治疗措施有效性的价值。在度假村治疗结束时对患者进行测试时,发现RP高的1组患者效果最大。在第2组患者中观察到的效果较小,特别是第3组。结论:使用一种基于数学模型的方法来评估接受支架植入术的AMI患者的RP,可以预测患者在度假村条件下二期医学康复的结果。
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[Predicting the results of rehabilitation treatment of patients with acute myocardial infarction who underwent coronary artery stenting: focus on the rehabilitation potential].

The search for ways to assess the rehabilitation potential (RP) in patients with acute myocardial infarction (AMI) who have undergone stenting remains relevant, which will allow personalizing approaches to prescribing treatment complexes necessary for a particular patient, increasing their effectiveness and reducing the likelihood of complications.

Objective: To develop a method for assessing RP in patients in the acute period of myocardial infarction and to evaluate its role in predicting the effectiveness of therapeutic measures in the early recovery period.

Material and methods: The study consisted of two parts. In the first part, a method for assessing the RP of patients with AMI was created using mathematical modeling methods. For this purpose, the analysis of discharge epicrisis of 137 patients (training sample) with AMI aged from 34 to 85 years (average age 59.4±2.1 years) was carried out. In the second part of the study, the results of rehabilitation measures were analyzed in these patients who, after the intensive care unit and intensive care unit, were transferred to the cardiology department of Angara Clinical Resort JSC. At the end of the II stage of rehabilitation, a multidisciplinary team evaluated the effectiveness of treatment of patients using integral indicators characterizing the clinical condition of a patient who has undergone acute coronary syndrome and stenting.

Results: In the first part of the study, devoted to the development of a mathematical model for assessing the RP of patients with AMI, an algorithm of methodology was created: a formalized patient map was formed, the evidence base was represented by 109 indicators; certain indicators were assigned the values of coefficients of linear classification functions, depending on which the patient fell into one of three groups: group 1 - high RP; group 2 - medium RP; group 3 - low RP. The second part of the study was devoted to determining the value of RP for predicting the effectiveness of therapeutic measures in the early recovery period (stage II of medical rehabilitation). When testing patients at the end of treatment at the resort, it was found that the greatest effect was observed in group 1 patients with high RP. A lesser effect was observed in patients of group 2 and, especially, group 3.

Conclusion: The use of a method for assessing RP based on mathematical modeling in AMI patients who have undergone stenting allows predicting the results of medical rehabilitation of patients at stage II in the conditions of the resort.

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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
59
期刊介绍: The journal deals with the study of the mechanism of a physiological and therapeutic effect of physical and health resort factors, methods and results of their employment, as well as with theoretical and practical problems involved in the use of exercise therapy in combined treatment of different diseases. The results of research and experience of using physical and health resort methods in medical practice and organization of physiotherapeutic and sanatorial and health resort service, book reviews on physiotherapy, health resort science and exercise therapy are published. Scientific life of allied specialities, proceedings of congresses, conferences, symposia (including foreign), the activity of republican and local societies, etc., are covered.
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