有氧运动、循环阻抗运动对射血分数中间型心力衰竭患者心肺运动试验参数、心功能的影响

Effects of aerobic exercise and circulatory impedance exercise on cardiopulmonary exercise test parameters and cardiac function in patients with heart failure with mid-range ejection fraction

目的 探讨循环阻抗运动、有氧运动对射血分数中间型心力衰竭(HFmrEF)患者心肺运动试验参数、心功能的影响。方法 选择HFmrEF患者150例,采用随机数表法分为对照组、有氧运动组(有氧组)、循环阻抗运动组(阻抗组),各50例。对照组予常规药物治疗,有氧组在常规药物治疗的基础上予有氧运动治疗,阻抗组在常规药物治疗的基础上予循环阻抗运动治疗,3组均治疗12周。观察3组入院后1周、12周的心肺运动试验参数、心功能。结果 与入院后1周时比较,入院后12周,各组患者峰值氧耗量(Peak VO_(2))、无氧代谢阈值时氧耗量(AT)值均升高,且阻抗组及有氧组均高于对照组;阻抗组AT值高于有氧组;二氧化碳通气当量斜率(VE/VCO_(2))均降低,且阻抗组及有氧组均低于对照组(P<0.05)。与入院后1周时比较,入院后12周,各组患者左室射血分数(EF)均升高,且阻抗组高于有氧组、对照组,有氧组高于对照组;血清氨基末端脑钠肽前体(NT-proBNP)水平均降低,且阻抗组低于有氧组、对照组,有氧组低于对照组(P<0.05)。结论 与常规药物治疗比较,有氧运动、循环阻抗运动能够显著改善HFmrEF患者氧代动力学、血流动力学及心功能,其中循环阻抗运动改善效果较明显。

Objective To explore the effects of circulatory impedance exercise and aerobic exercise on cardiopulmonary exercise test parameters and cardiac function of patients with heart failure with mid-range ejection fraction(HFmrEF).Methods A total of 150 patients with HFmrEF were selected and divided into the control group,the aerobic exercise group and the circulatory impedance exercise group according to random number table method,with 50 cases in each group.The control group was treated with conventional drug therapy,the aerobic exercise group was treated with aerobic exercise therapy on the basis of the treatment of conventional drug therapy,and the circulatory impedance exercise group was treated with circulatory impedance exercise on the basis of treatment of conventional drug therapy.All of the groups were treated for 12 weeks.The cardiopulmonary exercise test parameters and cardiac function of 3 groups were observed at 1 week and 12 weeks after admission.Results Compared with 1 week after admission,the peak oxygen consumption(Peak VO2)and anaerobic metabolic threshold oxygen consumption(AT)values of all of the groups increased at 12 weeks after admission,and both the circulatory impedance exercise group and the aerobic exercise group were all higher than the control group;The AT value of the circulatory impedance exercise group was higher than that of the aerobic exercise group;The ventilation equivalent slope of carbon dioxide(VE/VCO2)decreased,and the circulatory impedance exercise group and the aerobic exercise group were lower than the control group(P<0.05).Compared with 1 week after admission,at 12 weeks after admission,the left ventricular ejection fraction(EF)of all of the groups increased,and the circulatory impedance exercise group was higher than the aerobic exercise group and the control group,and the aerobic exercise group was higher than the control group;The level of serum N-terminal pro-brain natriuretic peptide(NT proBNP)precursor decreased,and the circulatory impedance exercise group was lower than the aerobic exercise group and the control group,and the aerobic exercise group was lower than the control group(P<0.05).Conclusion Compared with conventional drug therapy,aerobic exercise and circulatory impedance exercise can significantly improve oxygen dynamics,hemodynamics and cardiac function in patients with HFmrEF,and circulatory impedance exercise has the more significant improvement effect.