CAJ | 학술논문

【目的】探讨体位干预对急性冠脉综合征（ACS）患者妊娠相关血浆蛋白‐A（PAPP‐A）水平的影响。【方法】选择本院2011年8月到2013年12月收治的120例ACS患者，其中男71例，女49例，年龄20～80岁，将其随机分为对照组（ n ＝60）和观察组（ n ＝60）。所有患者均给予常规急诊介入治疗，对照组入院后前3 d绝对平卧位休息，观察组患者在发病d1内即给予逐级45°半卧位干预，两组都在d4逐渐增加活动量。检测两组患者入院后24 h内及入院d4血清PAPP‐A水平，记录患者的心输出量（CO）、心脏指数（CI）、射血分数（LVEF）和缩短分数（FS）。观察两组在入院4 d内发生的不适情况，包括腰背酸痛、失眠、排尿困难、便秘、焦虑等。【结果】与干预前比较，两组患者血清PA PP‐A水平均明显降低，干预后观察组血清PA PP‐A水平明显低于对照组，差异均具有统计学意义（均 P ＜0．05）；与对照组相比，干预后观察组的CO、CI值明显高于对照组，差异有统计学意义（ P ＜0．05）；在体位干预期间，观察组腰背酸痛、排尿困难及焦虑的发生率明显低于对照组，差异具有统计学意义（ P ＜0．05）。【结论】PAPP‐A在ACS发生及发展中具有重要作用，早期的体位干预能有效降低血清PAPP‐A水平，减少不适症状，改善心功能。
【목적】탐토체위간예대급성관맥종합정（ACS）환자임신상관혈장단백‐A（PAPP‐A）수평적영향。【방법】선택본원2011년8월도2013년12월수치적120례ACS환자，기중남71례，녀49례，년령20～80세，장기수궤분위대조조（ n ＝60）화관찰조（ n ＝60）。소유환자균급여상규급진개입치료，대조조입원후전3 d절대평와위휴식，관찰조환자재발병d1내즉급여축급45°반와위간예，량조도재d4축점증가활동량。검측량조환자입원후24 h내급입원d4혈청PAPP‐A수평，기록환자적심수출량（CO）、심장지수（CI）、사혈분수（LVEF）화축단분수（FS）。관찰량조재입원4 d내발생적불괄정황，포괄요배산통、실면、배뇨곤난、편비、초필등。【결과】여간예전비교，량조환자혈청PA PP‐A수평균명현강저，간예후관찰조혈청PA PP‐A수평명현저우대조조，차이균구유통계학의의（균 P ＜0．05）；여대조조상비，간예후관찰조적CO、CI치명현고우대조조，차이유통계학의의（ P ＜0．05）；재체위간예기간，관찰조요배산통、배뇨곤난급초필적발생솔명현저우대조조，차이구유통계학의의（ P ＜0．05）。【결론】PAPP‐A재ACS발생급발전중구유중요작용，조기적체위간예능유효강저혈청PAPP‐A수평，감소불괄증상，개선심공능。
[Objective] To explore the effects of behavioral interventions on the level of pregnancy‐associ‐ated plasma protein A (PAPP‐A) in acute coronary syndrome (ACS) patients .[Methods]A total of 120 ACS patients were randomly divided into observation and control groups (n=60 each) .All patients received con‐ventional emergency interventions .The control group took a 3‐day absolute supine rest while the observation group received gradual 45°semi‐recumbent interventions within 1 day .As of Day 4 ,both groups undertook gradual activity .[Results] The incidences of back pain ,voiding difficulties and anxiety of observation group during interventions were significantly less than those of control group ( P<0 .05) .The first defecation time of observation group was significantly less than that of control group ( P<0 .05) .After interventions ,the se‐rum level of PAPP‐A in both groups showed a distinct downward trend with significant difference ( P <0 .05) .After interventions ,it was significantly lower in observation group than that in control group ( P <0 .05) .The post‐intervention values of cardiac output (CO) ,cardiac index (CI) ,left ventricular ejection frac‐tion (LVEF) and shortening fraction (SF) were significantly higher in observation group than those in control group ( P <0 .05) .[Conclusion] PAPP‐A plays important roles in the development of acute coronary syn‐drome .And behavioral interventions of cardiac function can effectively reduce the expression of PAPP‐A ,less‐en symptoms and improve heart functions .