徒步行走训练对慢性心力衰竭患者运动耐量的影响

Effect of exercise of walking on foot on exercise tolerance in chronic heart failure patients

目的探讨徒步行走训练对慢性心力衰竭(chronic heart failure,CHF)患者运动耐量的影响。方法将81例CHF患者随机分为实验组和对照组。两组在常规抗心力衰竭药物治疗和护理的基础上,实验组增加徒步行走训练与指导,并于训练后第4w、8w、12w、16w、20w、24w分别测量两组患者6min步行试验(6MWT)的距离。结果两组患者于上述6个时间段6MWT的距离分别为,实验组:268.72±57.55m、313.54±51.39m、340.87±52.41m、355.36±47.01m、385.42±45.84m、404.50±38.05m;对照组:264.87±60.31m、298.56±60.28m、324.75±56.29m、338.59±60.80m、349.03±57.25m、378.96±49.41m。训练后20w、24w两组患者6MWT的距离比较,均P<0.05,差异有统计学意义;而训练前和训练后4w～16w两组患者6MWT的距离比较,均P>0.05,差异无统计学意义。结论持之以恒、规律性的徒步行走训练能提高CHF患者的运动耐量。

Objective To study the effect of exercise of walking on foot on exercise tolerance in chronic heart failure （CHF） patients. Methods 81 CHF patients were randomly divided into two groups： training group（n=39）,undergoing training of walking on foot under a nurse＇s supervision and control group（n=41） only receiving routine treatment with anti-cairdia failure drugs and routine nursing. The distances all the CHF patients walked on foot within 6 minutes at week 4, 8, 12, 16, 20 and 24 were measured. Results The distances measured at the six time points were 268.72 ± 57.55 m, 313.54 ± 51.39 m, 340.87 ± 52.41 m, 355.36 ± 47.01 m, 385.42 ± 45.84 m, 404.50 ± 38.05 m in the training group, and 264.87 ± 60.31 m, 298.56 ± 60.28 m, 324.75 ± 56.29 m, 338.59 ± 60.80 m, 349.03 ± 57.25 m, and 378.96± 49.41 m in the control group, respectively. There were significant differences at week 20 and week 24 after taking exercises （P 〈 0.05）, but insignificant from weeks 4 to 16 （P 〉 0.05）. Conclusion A persistent exercise of walking on foot may improve the exercise tolerance in chronic heart failure patients.