摘要
目的:观察老年慢性心力衰竭患者经运动训练后心功能和运动耐力的变化。方法:选择2002-01/2004-01在沈阳市第五人民医院心脏科住院慢性心力衰竭患者80例。年龄55～76岁。随机将患者分为训练组和对照组各40例。两组患者均接受常规药物治疗,训练组在接受常规药物治疗的基础上,在医生的指导下进行运动训练:在病情稳定后,逐渐增加运动量,每一运动强度级(2.0～3.0,3.0～4.0,4.0～5.0,5.0～6.0METs)原则上维持2周,若无不适即可进入下一运动强度级;若仍感吃力或运动中有问题时,应仍停在此心功能级,运动方式为步行,以步速及步行距离调整运动强度。两组分别在入院时和干预2个月后接受6min步行试验和心脏超声心动图检查,测定患者左室直径、左室短轴缩短率、左室射血分数。结果:按意向处理分析,最终进入结果分析慢性心力衰竭患者80例。训练组干预2个月后,6min步行距离明显长于入院时和对照组[(490±36),(406±40),(411±34)m,t=2.43,2.21,P<0.05];左室射血分数明显大于入院时和对照组[(40.1±5.2)%,(30.4±6.7)%,(27.9±5.0)%,t=1.89,2.11,P<0.05]。结论:适度的运动训练可改善慢性心力衰竭患者左室心功能,并显著提高其运动耐力。
AIM:To observe the changes of cardiac function and exercise endurance after ex ercise training in elderly patients with chronic heart failure(CHF). METHODS:Eighty CHF patients at 55 to 76 years of age,who were hospitalized in the Department of Cardiology,Shenyang Fifth People's Hospital between January 20 02 and January 2004,were randomly divided into training group(n=40) and control group(n=40).Patients in both groups were treated with regular drug therapy,besid es those in the training group took part in exercise training under the instruct ion of physicians:the amount of exercise was added gradually with the stablizati on of disease,each degree of exercise intensity(2.0 to 3.0,3.0 to 4.0,4.0 to 5.0 ,5.0 to 6.0 METs) was kept for two weeks in principle,the patients could come to the next degree if they were not unwell,and they should stop at this degree if they felt burdensome or had problems during exercise.The mode of exercise was wa lking, and the exercise intensity was adjusted with gait speed and walking dista nce.All the patient received 6 minute walking test and echocardiography(ECG) at hospitalization and two months after intervention,their left ventricular diamet er,left ventricular fractional shortening and left ventricular ejection fraction (LVEF) were determined. RESULTS:According to intention to treat(ITT) analysis,all the 80 CHF patient s were involved in the final analysis of results.Two months after intervention,6 minute walking distance in the training group[(490±36) m] was obviously longe r than that at hospitalization[(406±40) m] and that in the control group[(411± 34) m] (t=2.43,2.21,P< 0.05);LVEF in the training group[(40.1±5.2)%] was remar kably higher than that at hospitalization[(30.4±6.7)%] and that in the control group[(27.9±5.0)%] (t=1.89,2.11,P< 0.05). CONCLUSION:Moderate exercise training can ameliorate the left ventricular card iac function of CHF patients and improve significantly their exercise endurance.
出处
《中国临床康复》
CSCD
北大核心
2005年第16期170-171,共2页
Chinese Journal of Clinical Rehabilitation
