使用代谢当量概念行康复训练对慢性心力衰竭患者生活质量的影响

Effect of METs concept line rehabilitation exercise on the quality of life in patients with chronic heart failure

目的探讨慢性心力衰竭患者使用代谢当量（METs）概念行康复训练对其生活质量的影响。方法选择2016年8月至2017年5月在本院就诊的慢性心力衰竭患者100例，根据随机对照法分为对照组（n=50）和观察组（n=50），两组患者出院后均接受正规抗心力衰竭治疗（包括利尿剂、地高辛、B受体阻滞剂、ACEI等）。观察组患者经改良Bruce平板运动试验后，以METs为引导进行康复训练，对照组以靶心率为引导进行康复训练，评估两组患者在出院后1、3、6、12个月的6min步行试验、明尼苏达心力衰竭生活质量评分、患者因出现症状而停止活动率。结果出院后第1、3个月两组明尼苏达心力衰竭生活质量评分、6min步行试验改善均不明显，出院后第6、12个月两组的明尼苏达心力衰竭生活质量评分对照组为（66．7±7．8]分、（60．8±5．6）分，观察组为（61．3±6．5）分、（52．9±4．7）分，6min步行试验指标对照组为（324．4±11．7）m、（350．8±12．0）m，观察组为（346．0±17．8）m、（364．0±19．6）m均有改善，且观察组指标优于对照组，差异有统计学意义（P〈0．05）。观察组在出院后6、12个月因出现症状而停止活动率分别为22例（44．0％）、20例（40．0％）显著低于对照组的38例（76．0％）、36例（72．0％），差异有统计学意义（P〈0．05）。结论慢性心力衰竭患者使用METs概念行康复训练可提高患者的生活质量和心功能水平，值得临床推广。

Objective To explore the effect of rehabilitation exercise on the quality of life of patients with chronic heart failure using the concept of metabolic equivalent （METs）. Methods From August 2016 to May 2017, 100 cases of chronic heart failure patients in our hospital were selected, according to the random control method, divided into the control group （ n= 50 ） and the observation group （ n= 50 ）, two groups of patients received regular anti heart failure after discharge（ included diuretics, Digoxin, β blockers, ACEI, etc. ）, after the modified Bruce plate exercise test, the METs was taken as the guidance for the rehabilitation exercise in the observation group, and the targeted heart rate was taken as the guidance for rehabilitation exercise in control group. Patients in both groups were evaluated for a 6-min walking trial 1, 3, 6, and 12 months after discharge, for a Minnesota heart failure quality of life score, and for symptomatic cessation rates. Results There was no significant improvement in the quality of life score of Minnesota heart failure and the 6-min walking test at 1 and 3 months after discharge. At sixth and twelfth months after discharge, the quality of life score of heart failure in Minnesota in the control group was （66.7±7.8）, （60.8±5.6）, the observation group was （61.3±6.5）, （52.9±4.7）, the six minute walk test in the control group was （324.4±11.7）m, （350.8±12.0）m, the observation group was （346.0±17.8） m, （364.0±19.6）m, all were improved, and the index of the observation group was better than that of the control group, the difference was statistically significant （P〈0.05）. At 6 months and 12 months after discharge, 22 cases （44.0%） and 20 cases （40.0%） of the observation group stopped activity due to symptoms, which were significantly lower than those of the control group （38 cases） （76.0%） and 36 cases （72.0%）, the difference was statistically significant （P〈0.05）. Conclusion The rehabilitation exercise of METs concept in patients with chronic heart failure can improve the metabolic equivalent of the patients, improve the quality of life and the level of heart function, which is worthy of clinical promotion.