慢性心衰高强度间歇运动序贯中等强度持续运动治疗模式的初步研究

High-intensity interval training followed by moderate intensity aerobic continuous exercise model for chronic heart failure

目的:比较高强度间歇运动序贯中等强度持续运动(HFM)与单纯中等强度持续运动(MCE)在慢性心衰患者康复治疗中的效果。方法:筛选符合条件的慢性心衰(CHF)患者78例,分为HFM组和MCE组,每组39例。HFM组的运动方案为12周高强度间歇运动序贯中等强度持续运动训练,MCE组为12周中等强度持续运动训练。运动康复前后采用心肺运动测试(CPET)测试2组患者心肺功能变化,评估康复效果。结果:前8周,HFM组每周运动后即刻的心率收缩压乘积(RPP)、主观用力评分(RPE)值均显著高于MCE组(P<0.05),高强度间歇运动(HIIT)后RPP值上升都在正常可控范围内,休息5min后恢复接近安静水平。训练12周后,2组患者的通气无氧阈(AT)、最大摄氧量(PeakVO2)、峰值氧脉搏、一秒用力呼气容积(FEV1%)、左心室射血分数(LVEF)均显著高于治疗前(均P<0.05),HFM组的AT、PeakVO2、峰值氧脉搏及LVEF均显著高于MCE组(均P<0.05)。结论:高强度间歇运动序贯中等强度持续运动治疗模式较中等强度持续运动更能安全且有效地提升慢性心衰患者的心肺功能。

Objective:To compare the effect of high-intensity interval training followed by moderate intensity aerobic continuous exercise(HFM) model and moderate intensity aerobic continuous exercise(MCE) in the treatment of patients with chronic heart failure.Methods:Seventy-eight patients were randomly divided into a HFM group and a MCE group(n=39 for each). HFM group was given 12-week HFM. MEC group was subjected to 12-week MEC. Cardiopulmonary exercise test(CPET) was performed to assess the change of cardio-pulmonary ability at baseline and after 12 weeks, to determine whether the HFM model was safe and effective.Results:In the first 8 weeks, rate pressure product(RPP) and rating of perceived exertion(RPE) in HFM group each week were significantly higher than in MCE group after training(P<0.05). After high-intensity interval training(HIIT), RPP rose in the normal controllable range, and it was close to quiet after 5 min of rest. After 12-week training, anaerobic threshold(AT), maximal oxygen uptake(Peak VO2), peak oxygen pulse, forced vital capacity(FVC), forced expiratory volume in one second/forced vital capacity%( FEV1%) and left ventricular ejection fraction(LVEF) in two groups were significantly higher than before training(P<0.05), and those in HFM group were significantly higher than in MCE group(P<0.05). Conclusion: HFM model was safer and more effective in improving cardio-pulmonary function in patients with chronic heart failure.