有氧运动训练对老年冠心病慢性心力衰竭患者血清和肽素水平影响

Influence of aerobic exercise training on serum copeptin level in aged patients with coronary heart disease complicated chronic heart failure

目的:探讨有氧运动训练对老年冠心病合并慢性心力衰竭患者血清和肽素的影响。方法:选择老年冠心病合并慢性心力衰竭患者200例,随机均分为常规治疗组(给予强心、利尿等常规治疗)和有氧运动组(在常规治疗方案的基础上同时给予有氧运动训练),6个月后,检测两组患者血清和肽素水平,并评估患者心功能、生活质量。结果:与治疗前比较,两组6个月后血清和肽素表达水平均明显降低(P均<0.05),且有氧运动组明显低于常规治疗组[(9.24±3.82)pmol/ml比(10.85±2.66)pmol/ml,P=0.036]。与常规治疗组比较,有氧运动治疗组心功能明显改善,6min步行距离[(185.3±51.8)m比(386.5±62.4)m]明显增加,明尼苏达心力衰竭生活质量量表评分[(32.5±5.5)分比(21.8±4.2)分]明显降低(P均<0.05);患者在有氧运动治疗中未发生心衰加重、恶性心律失常等不良事件。结论:慢性心力衰竭患者在药物治疗的基础上,进行有氧运动训练可以降低血清和肽素的水平,改善心功能,提高生活质量。

Objective： To explore influence of aerobic exercise training on serum copeptin level in aged patients with coronary heart disease （CHD） complicated chronic heart failure （CHF）. Methods： A total of 200 aged CHD ＋ CHF patients were randomly and equally divided into routine treatment group （received cardiotonic, diuretic etc. routine therapy） and aerobic exercise group （received aerobic exercise training based on routine therapy）. After six months, serum copeptin level was measured, cardiac function and quality of life were assessed and compared between two groups. Results.. Compared with before treatment after six months, serum copeptin level significantly reduced in both groups （P〈0.05 all） ; compared with routine treatment group, there was significant reduction in serum copep- tin level [ （10.85 ± 2.66） pmol/ml vs. （9. 24 ± 3.82） pmol/ml, P = 0. 036] in aerobic exercise group. Compared with routine treatment group, there was significant improvement in cardiac function, significant rise in 6min walk- ing distance [ （185. 3± 51.8） m vs. （386.5 ± 62. 4） m], and significant reduction in score of Minnesota living with heart failure questionnaire [ （32.5 ± 5.5） scores vs. （21.8 ± 4.2） scores] in aerobic exercise group, P〈0.05 both; no patients suffered from adverse events such as aggravated heart failure and malignant arrhythmia etc. during aero- bic exercise therapy. Conclusion.. On the basis of drug treatment, aerobic exercise training can reduce serum copeptin level, improve cardiac function and.quality of life in patients with chronic heart failure.