心脏康复锻炼对行维持性血液透析的慢性肾衰竭合并心功能不全患者心功能指标的影响

Effect of cardiac rehabilitation exercise on the cardiac function indicators of patients with chronic renal failure and heart failure undergoing maintenance hemodialysis

目的分析心脏康复锻炼对行维持性血液透析(MHD)的慢性肾衰竭合并心功能不全患者心功能指标的影响。方法选取江门市新会区中医院2018年1月至2019年9月期间接受MHD治疗的慢性肾衰竭合并心功能不全患者80例,按照随机数字法分为对照组和观察组,每组40例。对照组患者予常规干预,观察组患者予心脏康复锻炼。比较两组患者心功能、肾功能、运动耐量和生活质量。结果干预后,观察组的左室收缩末内径(LVEDs)、左室舒张末内径(LVEDd)和左室质量指数(LVMI)均显著低于对照组(P值均<0.05),心脏指数(CI)、左心室内径缩短率(FS)和左室射血分数(LVEF)均显著高于对照组(P值均<0.05);尿素下降率(URR)显著低于对照组(P<0.05),尿素清除指数(Kt/V)、6 min步行距离均显著高于对照组(P值均<0.05);生活质量各维度分值均显著高于对照组(P值均<0.05)。结论对行MHD的慢性肾衰竭合并心功能不全患者予心脏康复锻炼可改善其心、肾功能,提高运动耐量和生活质量。

Objective To analyze the effect of cardiac rehabilitation exercise on cardiac function indicators of patients with chronic renal failure and heart failure undergoing maintenance hemodialysis(MHD).Methods A total of 80 patients with chronic renal failure and heart failure who were treated with MHD in Hemodialysis Room at Xinhui Hospital of Traditional Chinese Medicine from January 2018 to September 2019 were selected and divided into a control group and an observation group according to the random number method,with 40 cases in each group.The control group received routine intervention,and the observation group received cardiac rehabilitation exercise.The cardiac function,renal function,exercise tolerance and quality of life were compared between the two groups.Results After the intervention,the left ventricular end-systolic dimension(LVEDs),left ventricular end-diastolic dimension(LVEDd)and left ventricular mass index(LVMI)of the observation group were significantly lower than those of the control group,while the cardiac index(CI),fractional shortening(FS)and left ventricular ejection fraction(LVEF)were significantly higher than those of the control group(all P<0.05).The urea reduction ratio(URR)was significantly lower than that of the control group,and the urea clearance index(Kt/V)and 6-min walking distance were significantly higher than those of the control group(all P<0.05).The scores of various items of quality of life were higher than those of the control group(all P<0.05).Conclusion Cardiac rehabilitation exercise for MHD patients with chronic renal failure and heart failure can improve their cardiac and renal function,and improve their exercise tolerance and quality of life.