步行运动训练在冠心病心力衰竭患者中的临床价值

Clinical Value of Walking Exercise in Patients With Coronary Artery Disease Combining Heart Failure

目的:探讨冠心病心力衰竭患者在常规药物治疗情况下辅以步行运动训练对其疗效的影响。方法:连续选取我院冠心病心力衰竭患者80例,随机分为两组,运动组40例,男25例,女15例,平均年龄(61.2±9.8)岁;对照组40例,男26例,女14例,平均年龄(58.1±10.9)岁。两组患者均给予心力衰竭常规药物治疗,运动组在常规治疗基础上辅以6分钟步行运动训练。3个月后观察两组患者治疗前、后血浆B型利钠肽(BNP)水平及6分钟步行距离变化情况。结果:两组患者在常规冠心病心力衰竭药物治疗3个月后左心室收缩未径(LVESD)、左心室舒张未径(LVEDD)、左心室射血分数(LVEF)、血浆BNP水平和6分钟步行运动试验(除对照组LVESD、LVEDD外)较入院时均有明显改善(P<0.05),差异有统计学意义。运动组治疗3个月后LVEF、血浆BNP水平和6分钟步行运动试验较对照组均有明显改善(P<0.05),差异有统计学意义。结论:步行运动训练可显著提高心力衰竭患者的运动耐量,在冠心病心力衰竭常规药物治疗同时辅以步行运动训练更加有利于其心功能的恢复。应当鼓励冠心病心力衰竭患者进行运动锻炼,以改善生活质量。

Objective： To investigate the efficacy of supplemental walking training in patients with coronary artery disease （CAD） combining heart failure （HF） trader routine medication. Methods： A total of 80 patients with CAD combining HF were randomly divided into 2 groups： Exercise group, n=40 including 25 male and 15 female at （61.2±9.8） years of age, the patients received additional six-minute walking exercise training based on routine medication and Control group, n-40 including 26 male and 14 female at （58.1±10.9） years of age, the patients received routine medication. All patients were treated for 3 months. Plasma levels of BNP and general conditions at before and after the treatment were compared between 2 groups. Results： ① After 3 months treatment, both groups had significantly improved LVESD, LVEDD, LVEF, plasma levels of 13NP and six-minute walk test （except LVESD and LVEDD in Control group）, all P〈0.05. ② Compared with Control group, Exercise group showed obviously improved LVEF, plasma level of BNP and six-minute walk test, all P〈0.05. Conclusion： Walking training may increase the exercise tolerance, which is beneficial to recover the cardiac function in patients with CAD combining HF in addition to routine medication.