海南医科大学学报

目的:探讨减重支持运动疗法对慢性心力衰竭(CHF)患者心功能及生活质量的影响。方法:选取75例CHF患者随机分为对照组(n=37)与观察组(n=38),对照组进行常规药物治疗,观察组在对照组的基础上给予减重支持运动疗法进行康复治疗,治疗周期6个月。检测治疗前后两组血浆脑钠肽(BNP)及醛固酮水平,比较两组相关心功能指标;分别采用6 min步行实验及明尼苏达生活量表(MHL)评价患者的运动耐量及生活质量。结果:两组治疗前血浆BNP、醛固酮水平,各心功能指标,6min步行距离及MHL评分比较,差异均无统计学意义(P>0.05);两组治疗后BNP、醛固酮水平明显降低,且观察组变化值明显大于对照组,差异具有统计学意义(P<0.01);两组心率(HR)、左室舒张末期内径(LVEDd)及MHL评分降低,射血分数(LVEF)、左室内径缩短率(FS)及6min步行距离增大,差异均具有统计学意义(P<0.05或P<0.01)。结论:减重支持运动疗法可明显降低CHF患者血浆BNP及醛固酮水平,改善患者心功能,并提高患者运动耐量及生活质量。

Objective:To explore the effect of weight support exercise therapy on the cardiac function and living quality in patients with chronic heart failure(CHF).Methods:A total of 75 patients with CHF were included in the study and randomized into the observation group(n=38)and the control group(n=37).The patients in the control group were given routine drug therapy.On the above basis,the patients in the observation group were given weight support exercise therapy for rehabilitation.Six-month treatment was regarded as one course.The plasma BNP and aldosterone levels before and after treatment in the two groups were detected.The related cardiac function indicators in the two groups were compared.6MWT and MHL were used to evaluate the exercise tolerance and living quality,respectively.Results:The comparison of plasma BNP andaldosterone levels,various cardiac function indicators,6min walking distance,and MHL score before treatment between the two groups was not statistically significant(P>0.05).BNP and aldosterone levels after treatment in the two groups were significantly reduced,and the reduced degree in the observation group was significantly greater than that in the control group(P<0.01).After treatment,HR,LVEDd,and MHL score were significantly reduced,LVEF,FS,and 6min walking distance were significantly increased,and the comparison between the two groups was statistically significant(P<0.05 or P<0.01).Conclusions:Weight support exercise therapy can significantly reduce the plasma BNP and aldosterone levels in CHF patients,improve the cardiac function,and enhance the exercise tolerance and living quality.