慢性心衰患者对不同运动类型的耐受性

A Clinical Research of Chronical Heart Failure Patients’ Tolerance to Different Movement Types

目的探究不同部位(左/右)慢性心衰患者对不同运动类型的耐受性。方法将2013年4月至2017年12月到湖北省宜昌市中心人民医院(三峡大学第一临床医学院)心内科住院符合纳入标准且符合NYHA分级为二级的60例心衰患者纳入研究,根据心衰部位(左心/右心)不同严格分为左心衰组36例和右心衰组24例;同时对2组中每例患者采用严格的对照匹配。以跑步速度及心肌耗氧量探究2组患者对高强度运动的耐受性差异;以慢跑(6 km/h)时间及运动总量(MET)研究2组患者对运动量的耐受性差异。结果与对照匹配组相比左慢性心衰组最大运动速度及最大心肌耗氧量均明显降低[(11.5±1.45) km/h vs (7.9±1.25) km/h,P<0.01];[(9 125.4±1 288.5) vs (7 484.3±781.94),P<0.01)];与对照匹配组相比右慢性心衰组最大运动速度及最大心肌耗氧量降低[(10.4±1.09) km/h vs (9.9±1.41) km/h,P<0.05];[(9 702.5±1 696.07.94) vs (9 238.8±1474.60),P=0.01]。与对照匹配组相比左慢性心衰组最大运动时间及最大运动量均明显降低[(42.1±13.89) min vs(26.0±7.41) min,P<0.01];[(168.6±55.54) MET vs (104.1±29.62) MET,P<0.01];与对照匹配组相比右慢性心衰组最大运动时间及最大运动量明显降低[(44.2±14.90) min vs (31.4±8.30) min,P<0.01];[(176.0±59.61) MET vs (125.5±33.21) MET,P<0.01)。结论 NYHA二级左心衰患者可能对于高强度或者耐力性运动完全不耐受;而对于NYHA二级的右心衰患者来说可能可以耐受一定强度和量的运动。

Objective To investigate the Chronical Heart Failure patients’ tolerance differences for different movement types. Me thods From April 2014 to December 2017, 70 CHF patients admitted into the Cardiology Department of People’s Central Hospital,Yi Chang,Hu Bei and complied with inclusion standards were selected as research subjects. According to the CHF sites,a total of 60 cases were divided into the left CHF group(36 cases) and the right CHF group(24 cases). At the same time strict matched control was applied thus each CHF case was matched with a healthy control case. Running speed and heart oxygen consumption were checked as the index of myocardial tolerance for high intensity movement,while jogging time(6 km/h) and total movement volume(MET) were tested as the index of movement volume. Then the index of myocardial tolerance for high intensity movement and the index of movement volume were compared between HGF groups and matched control groups. Re s ults Compared with the matched control group, the left HGF group’s maximal running speed and heart oxygen consumption were outstandingly lower [(11.5±1.45) km/h vs(7.9±1.25) km/h,P<0.01];[(9 125.4±1 288.5) vs(7 484.3±781.94),P<0.01) ];Compared with the matched control group,the right HGF group’s maximal running speed and heart oxygen consumption were lower [(10.4 ±1.09) km/h vs(9.9 ±1.41) km/h, P<0.05];[(9702.5 ±1696.07.94) vs(9 238.8±1474.60),P = 0.01]. Compared with the matched control group,the left HGF group’s maximal running time and running volume were outstandingly lower [(42.1 ±13.89) min vs(26.0 ±7.41) min,P <0.01];[(168.6 ±55.54) MET vs(104.1 ±29.62) MET, P <0.01];Compared with the matched control group,the right HGF group’s maximal running time and running volume were outstandingly lower[(44.2±14.90)min vs(31.4±8.30) min,P<0.01];[(176.0±59.61) MET vs(125.5±33.21) MET,P<0.01]. Conclus ion NYHA Grade II left CHF patients might be much less tolerant for movements(high intensity movement or endurance movement),however for right CHF patients, they could be able to tolerate a fixed degree high intensity and endurance movement.