运动康复治疗对心衰患者心功能及心率变异的影响

Effect of exercise rehabilitation therapy on cardiac function and heart rate variability in patients with heart failure

目的探讨运动康复治疗对心衰患者心功能及心率变异的影响。方法将86例心衰患者随机分为两组,各43例。对照组实施常规药物治疗,研究组在对照组基础上联合运动康复治疗,比较两组临床疗效、心功能[左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左室收缩末期内径(LVESd)]、心率变异性[R-R间期标准差(SDNN)、24 h内连续5min平均正常R-R间期标准差(SDANN)、24 h内相邻正常RR间期差值的均方根值(RMSSD)]。结果治疗后,研究组总有效率88.37%,高于对照组的69.77%(P<0.05);治疗后两组LVEF、SDNN、SDANN、RMSSD均较治疗前明显升高(P<0.05),仅研究组LVEDD、LVESd明显缩短(P<0.05),且治疗后研究组各项指标变化均较对照组明显改善(P<0.05或P<0.01)。结论运动康复治疗心衰患者临床效果显著,其通过有效提高患者心功能及调节心率变异性,继而达到降低患者病死率及再入院率的目的。

Objective To investigate the effect of exercise rehabilitation therapy on cardiac function and heart rate variability in patients with heart failure. Methods Eighty-six cases of patients with heart failure were divided into the control group and the experimental group by random number table method,43 cases in each group. The control group were treated with conventional medicines,while the experimental group were additionally treated with exercise rehabilitation. The clinical curative effect,cardiac function [left ventricular ejection fraction （LVEF）,left ventricular end diastolic diameter （LVEDD）,left ventricular end systolic diameter （LVESd） ]and heart rate variability indexes [standard diviation of normal to normal intervals （SDNN）,continuous 5 min average normal SDNN within 24 hours （SDANN）,root-mean-square value of adjacent normal RR interval difference within 24 hours （RMSSD） ]in two groups were observed. Results After treatment,the total effective rate of treatment in the experimental group was higher than that in the control group （88. 37% vs 69. 77%） （P 〈0. 05）. After treatment,LVEF,SDNN,SDANN and RMSSD of the two groups were significantly higher than those before treatment,the LVEDD and LVESd of only the experimental group were significantly lower than those before treatment,and the changes were more significant in the experimental group than the control group （P 〈0. 05 or P 〈0. 01）. Conclusion Rehabilitation therapy is effective in the treatment of patients with heart failure. It can reduce the mortality rate and readmission rate of patients through effectively improving the cardiac function and regulating the heart rate variability in patients.