6 min步行试验在体外反搏治疗Ⅱ~Ⅲ级慢性心力衰竭患者前后运动耐量中的评价

Evaluation of exercise tolerance before and after extracorporeal counterpulsation therapy in patients with gradeⅡ-Ⅲchronic heart failure using the 6-min walk test

目的探讨6 min步行试验(6-MWT)在体外反搏治疗Ⅱ~Ⅲ级慢性心力衰竭(CHF)患者前后运动耐量中的评价。方法选取2019年1月至2021年1月本院收治的400例Ⅱ~Ⅲ级CHF患者作为研究对象,按照随机数字表法分为对照组与观察组,各200例。对照组采用常规药物治疗,观察组在对照组基础上联合体外反搏治疗。比较两组治疗前后临床指标[左心室射血分数(LVEF)、脑钠肽(BNP)、去甲肾上腺素(NE)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)],比较心功能Ⅱ级与心功能Ⅲ级患者治疗前后6-MWT。结果治疗前,两组6-MWT、LVEF及BNP、NE、IL-6、TNF-α水平比较差异无统计学意义;治疗后,两组6-MWT均长于治疗前,LVEF均高于治疗前,BNP、NE、IL-6、TNF-α水平均低于治疗前,且观察组6-MWT长于对照组,LVEF高于对照组,BNP、NE、IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。治疗前,心功能Ⅱ级患者6-MWT长于心功能Ⅱ级患者,差异有统计学意义(P<0.05);治疗后,心功能Ⅱ级与心功能Ⅲ级患者6-MWT均长于治疗前,且心功能Ⅱ级患者长于心功能Ⅲ级患者,差异有统计学意义(P<0.05)。结论6-MWT操作简单、易行、经济,是评估体外反搏治疗Ⅱ~Ⅲ级CHF患者前后运动耐量的可靠、有效指标,可为临床治疗措施、判断预后提供依据,值得临床推广应用。

Objective To explore the evaluation of exercise tolerance before and after extracorporeal counterpulsation therapy in patients with gradeⅡ-Ⅲchronic heart failure(CHF)using the 6-min walk test(6-MWT).Methods 400 patients with gradeⅡ-ⅢCHF admitted to our hospital from January 2019 to January 2021 were selected as the research subjects,and they were divided into the control group and the observation group according to the random number table method,with 200 cases in each group.The control group was treated with conventional drugs,and the observation group was combined with extracorporeal counterpulsation therapy on the basis of the control group.The clinical indicators(left ventricular ejection fraction[LVEF],brain natriuretic peptide[BNP],norepinephrine[NE],interleukin-6[IL-6],tumor necrosis factor-α[TNF-α])were compared between the two groups before and after treatment,and the 6-MWT in patients with gradeⅡand gradeⅢcardiac function were compared before and after treatment.Results Before treatment,there was no statistically significant difference in 6-MWT,LVEF and BNP,NE,IL-6,and TNF-αlevels between the two groups;after treatment,6-MWT of the two groups was longer than before treatment,LVEF was higher than before treatment,BNP,NE,IL-6 and TNF-αleveles were lower thanbefore treatment,and 6-MWT in the observation group was longer than the control group,LVEF was higher than the control group,BNP,NE,IL-6 and TNF-αlevels were lower than the control group,and the differences were statistically significant(P<0.05).Before treatment,the 6-MWT in gradeⅡpatients was higher than gradeⅢpatients,and the difference was statistically significant(P<0.05);after treatment,6-MWT in gradeⅡand gradeⅢpatients were higher than before treatment,and the 6-MWT in gradeⅡpatients was longer than 6-MWT in gradeⅢpatients,and the differences were statistically significant(P<0.05).Conclusion The 6-MWT is simple,easy,and cost-effective method for evaluating exercise tolerance before and after extracorporeal counterpulsation therapy in patients with gradeⅡ-ⅢCHF,it provides a reliable and effective indicator for clinical treatment measures and prognosis assessment,it is worth promoting and applying in clinical practice.