DOI
https://doi.org/10.47689/2181-3663-vol4-iss4-pp46-54Kalit so‘zlar
miokard infarkti , teri orqali koronar intervensiya , yurak reabilitatsiyasi , jismoniy faollik , SDNN , ikkilamchi profilaktika , HADS , lipid profiliAnnotasiya
Zamonaviy reperfuzion davolash usullari, jumladan teri orqali koronar intervensiyalar (TKI) keng joriy etilishiga qaramay, miokard infarkti (MI) butun dunyo bo‘ylab bemorlarda muddatidan oldin o‘lim va nogironlikning asosiy sabablaridan biri bo‘lib qolmoqda. MIdan keyin bemorlarni kompleks davolashning eng muhim tarkibiy qismi yurak reabilitatsiyasi hisoblanadi. U organizmning funksional imkoniyatlarini tiklash, takroriy yurak-qon tomir asoratlari xavfini kamaytirish va bemorlarning hayot sifatini yaxshilashga qaratilgan tizimli jismoniy mashg‘ulotlarni o‘z ichiga oladi.
Ushbu tadqiqotning maqsadi funksional, gemodinamik, metabolik va psixoemotsional ko‘rsatkichlardagi o‘zgarishlarni baholash asosida MI va TKIdan keyingi bemorlarda jismoniy kardioreabilitatsiya samaradorligini tahlil qilishdan iborat.
Materiallar va usullar. Tadqiqotga standart farmakologik terapiya olgan va 4 haftalik jismoniy reabilitatsiya dasturidan o‘tgan 40-75 yoshdagi 68 nafar bemor (41 erkak va 27 ayol) kiritildi. Protokol o‘rtacha intensivlikdagi aerobik mashqlar (yurish, statsionar velosipedda harakatlanish), nafas olish mashqlari va davolovchi jismoniy tayyorgarlik elementlariga asoslangan edi. Dasturning samaradorligi 6 daqiqalik yurish testi, exokardiografiya, yurak urishi va qon bosimi monitoringi, yurak ritmi o‘zgaruvchanligi (SDNN) tahlili, lipid profili ko‘rsatkichlari va yuqori sezgir C-reaktiv oqsil darajasi, shuningdek, HADS shkalasi bo‘yicha psixoemotsional holat yordamida baholandi.
Natijalar. 4 haftalik kardioreabilitatsiya dasturi tugagandan so‘ng, bemorlarning aksariyatida barcha tahlil qilingan parametrlarning sezilarli yaxshilanishi kuzatildi. 6 daqiqalik yurish testida bosib o‘tilgan masofa 320 m dan 420 m gacha (p<0,001) oshdi, bu jismoniy chidamlilikning oshganligini ko‘rsatadi. Chap qorincha qon otish fraksiyasi 49,5% dan 53,1% gacha yaxshilandi (p = 0,002), ayniqsa dastlabki sistolik disfunksiyasi bo‘lgan bemorlar guruhida sezilarli yaxshilanish kuzatildi. Vegetativ gomeostaz yaxshilandi, bu SDNN ning 72 dan 93 ms gacha oshishi bilan tasdiqlandi (p < 0,001). Jismoniy mashqlarga javoban lipid almashinuvida ham ijobiy o‘zgarishlar qayd etildi: PZLP darajasi 0,8 mmol/l ga kamaydi (p<0,01), maqsadli ko‘rsatkichlarga (<1,8 mmol/l) erishgan bemorlar ulushi ikki barobar oshdi. hs-CRP darajasi 4,8 dan 2,9 mg/l gacha (p = 0,001) kamaydi, bu yallig‘lanishning pasayganini ko‘rsatadi. Bundan tashqari, psixoemotsional holatning yaxshilanishi qayd etildi, bu HADS shkalasi bo‘yicha xavotir va depressiya ko‘rsatkichlarining 2,7-2,9 ballga (p<0,001) pasayishi bilan ifodalandi.
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