呼吸肌训练对老年慢性射血分数保留心力衰竭患者心肺功能及心率变异性的影响

Effect of comprehensive respiratory muscle training on cardiopulmonary function and heart rate variability in elderly chronic heart failure with preserved ejection fraction

目的 探讨呼吸肌训练对老年慢性射血分数保留心力衰竭(简称心衰)患者肺功能、运动能力、心率变异性及心脏功能的影响。方法 选择2020年6月至2021年11月辽宁省金秋医院心脏康复中心收治的100例诊断明确的老年(年龄>65岁)慢性心衰患者,按照随机数字表法分为对照组和观察组,每组50例,两组患者均接受规范化的抗心衰药物治疗,观察组在此基础上进行呼吸肌训练,治疗12周后对两组患者的肺功能、运动能力、心率变异性及心脏超声等指标进行评价。结果 治疗12周后,观察组第1秒呼气容积、峰值摄氧量、6分钟步行距离、心率变异性高于治疗前,且高于对照组,差异有显著性(P<0.05);观察组用力肺活量、最大自主通气量高于治疗前,静息心率低于治疗前,差异有显著性(P<0.05);两组患者的左心室舒张末期内径、左心室收缩末期内径、左心室射血分数、左心房容量指数、二尖瓣舒张早期血流速度/二尖瓣环舒张早期运动速度比值与治疗前比较,差异均无显著性(P>0.05)。结论 呼吸肌训练可改善老年慢性心衰患者的心肺功能及心率变异性。

Objective To investigate the effect of comprehensive respiratory muscle training on lung function, exercise ability, heart rate variability and cardiac function in elderly chronic heart failure with preserved ejection fraction(HFrEF). Method 100 patients clearly diagnosed with chronic ejection fraction preserved heart failure in Liaoning Jinqiu Hospital from June 2020 to November 2021 were divided into control group and observation group according to the random number table method, with 50 cases in each group. Both groups received standardized anti-HF medication, and the observation group underwent respiratory muscle training. After 12 weeks of treatment,lung function, exercise ability, heart rate variability and cardiac ultrasound were evaluated in both groups. Result After 12 weeks treatment,forced expiratory volume in one second(FEV1), six-minute walk distance(6MWD), and maximal oxygen consumption(PeakO2) in the observation group were higher than before treatment, and higher than those in the control group(P<0.05);forced vital capacity(FVC)、maximal voluntary ventilation(MVV) in the observation group were higher than before treatment, while the resting heart rate was lower than before treatment(P<0.05);left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVEDD), left ventricular end systolic diameter(LVESD), left atrial volume index(LAVI), and E/e, was no difference in the two groups(P>0.05). Conclusion Respiratory muscle training can improve cardiopulmonary function and heart rate variability in elderly chronic heart failure with preserved ejection fraction.