运动康复治疗对射血分数保存心力衰竭患者运动耐力、舒张功能和生活质量的影响

发布时间：2018-03-10 05:25

本文选题：运动康复　切入点：射血分数保存心力衰竭　出处：《临床心血管病杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的:探讨运动康复治疗对射血分数保存心力衰竭(心衰)患者运动耐力、舒张功能和生活质量的影响。方法:入选了100例NYHA心功能Ⅱ~Ⅲ级,左室射血分数(LVEF)保存心衰患者,在药物治疗基础上,根据患者意愿分为运动康复组和对照组。运动康复组采用踏车运动康复,训练强度为基线水平症状限制性心肺运动试验测得的峰值氧耗量(peak VO_2)50%~80%。每周运动3次,每次40min。在基线及12周随访结束时通过心肺运动试验测peak VO_2,二氧化碳通气当量斜率(VE/VCO2slop),无氧阈氧耗量(VO_2AT),最大运动功率和最大运动时间;超声心动图仪检测并计算舒张早期二尖瓣血流速度与舒张早期二尖瓣环运动速度比(E/e'),左房容积指数(LAVI),左室肌重量指数(LVMI),LVEF;测试6 min步行距离;测血浆N端B型脑钠肽前体(NTproBNP);通过明尼苏达心衰生活质量问卷表(MLWHFQ)评估生活质量。并对上述指标进行组内及组间比较。结果:运动康复组及对照组随访12周后peak VO_2、VO_2AT、最大运动功率、最大运动时间及6min步行距离均较前增加(P0.05);VE/VCO2slop、E/e'、LAVI及MLWHFQ总分均较前下降(P0.05),但运动康复组优于对照组(P0.05)。LVMI、LVEF及NT-proBNP组内比较及组间比较差异无统计学意义(P0.05)。结论:运动康复治疗改善了LVEF保存心衰患者的运动耐力、左室舒张功能及生活质量。
[Abstract]:Objective: to investigate the effects of exercise rehabilitation therapy on exercise endurance, diastolic function and quality of life in patients with heart failure (HF) preserved by ejection fraction. On the basis of drug therapy, the patients were divided into two groups according to their wishes: exercise rehabilitation group and control group. The intensity of training was the peak oxygen consumption measured by the restricted cardiopulmonary exercise test at baseline level and 80 times a week. At the end of baseline and 12 weeks follow-up, peak VO _ 2 was measured by cardiopulmonary exercise test, V / V _ 2O _ 2slopa, oxygen consumption at anaerobic threshold, maximal exercise power and maximal exercise time. The ratio of mitral annular velocity to mitral annular velocity was measured by echocardiography, left atrial volume index (LVMIV), left ventricular mass index (LVMI) and left ventricular mass index (LVEF) were measured, and 6 min walking distance was measured. The plasma N-terminal B-type brain natriuretic peptide precursor (NTproBNPN) was measured, and the quality of life (QOL) was evaluated by the Minnesota Heart failure questionnaire (MLWHFQ). The above indexes were compared within and between groups. Results: peak was followed up 12 weeks after 12 weeks follow-up in the exercise rehabilitation group and the control group. Vo2s / Vo2ATs, maximum moving power, The maximal exercise time and 6-minute walking distance increased P0.05V / VCO _ 2slop-E / E / E / P _ (0.05), but the total scores of exercise rehabilitation group were better than that of control group (P _ (0.05)). LVMI / LVEF and NT-proBNP had no significant difference (P _ (0.05)). Conclusion: exercise rehabilitation therapy is improved. Good LVEF preserves the exercise endurance of patients with heart failure, Left ventricular diastolic function and quality of life.
【作者单位】：云南省第一人民医院心内科;
【分类号】：R541.6

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