个体化运动康复训练对慢性稳定性心力衰竭患者运动耐量的影响

Effects of Individualized Exercise Rehabilitation Training on Exercise Tolerance in Patients with Chronic Stable Heart Failure

目的:探讨个体化运动康复处方对慢性稳定性心力衰竭的临床效果。方法:将我院200例慢性稳定性心衰患者分为仅进行无运动的心脏康复处方治疗的对照组和在基础心脏康复处方上复合个体化运动康复处方治疗的试验组,评估患者运动和静息状态下心率和血压变化情况及平板运动试验的主要参数。结果:在运动状态下,试验组患者的心率、收缩压、舒张压、心率血压乘积和最大ST段压低幅度均显著低于对照组(均P<0.05),总运动时间、ST段压低1 mm时间、最大运动耐量指标均显著高于对照组(均P<0.05)。试验组患者静息室壁运动积分(WMS)和生活质量评分下降幅度显著高于对照组(P<0.05),而左心室射血分数(LVEF)和6分钟步行试验(6 MWT)评分升高幅度均明显高于对照组(均P<0.05)。结论:平板运动试验指导下的个体化运动康复治疗可有效提高慢性稳定性心力衰竭患者的运动能力,改善心功能并提高其生活质量,值得在临床上推广使用。

Objective:To explore the clinical effects of individualized exercise rehabilitation on chronic stable heart failure.Methods:A total of 200 patients with chronic stable heart failure in our hospital were divided into the control group with non-exercise cardiac rehabilitation treatment and the experimental group with individualized exercise rehabilitation added to the basic cardiac rehabilitation plan.The changes of heart rate and blood pressure during exercise and rest,and the main parameters of the treadmill exercise test were evaluated between these two groups.Results:The heart rate,systolic blood pressure,diastolic blood pressure,the product of heart rate and blood pressure,and depression amplitude of the maximum ST-segment in the experimental group were significantly lower than those of the control group in exercise state(all P<0.05).While total exercise time,time of ST-segment depression by 1 mm,and the maximum exercise tolerance index were significantly higher in the experimental group(all P<0.05).The reduction in resting wall motion score(WMS)and quality of life score,and the increase of left ventricular ejection fraction(LVEF)and 6-minute walk test(6 MWT)score were all obviously higher than those of the control group(all P<0.05).Conclusion:The individualized exercise rehabilitation guided by the treadmill exercise test could effectively improve exercise ability,ameliorate heart function and enhance life quality in patients with chronic stable heart failure,which is worthy of clinical application.