运动训练对慢性心力衰竭患者运动耐量的影响

Effect of skeletal muscle training on exercise tolerance in patients with chronic heart failure

目的 探讨运动训练对慢性心力衰竭患者运动耐量的影响。方法 70例患者随机分为 2组 ,A组 (n =3 4)运动培训 3周 ,B组 (n =3 6)限制活动 3周 ,然后比较 2组 6min内步行的距离、左室射血分数(超声心动图测定 )、血白介素 6(双抗体夹心法 )及去甲肾上腺素浓度 (荧光法测定 )的变化。结果 运动训练组患者试验后 6min步行距离 ( 3 85± 3 0 .12 )m ,血IL 6( 0 .86± 0 .2 5 ) pmol/L ,NE( 2 .0 5± 0 .48)nmol/L ,LVEF( 43± 5 .2 3 ) % ,上述各指标与对照组相比 ,差异均有显著性意义 (P <0 .0 5 ) ,而且运动试验组试验前、后各指标的差异也有显著性意义 (P <0 .0 5 ) ,但对照组试验前、后差异无显著性意义 (P >0 .0 5 )。结论 运动训练能改善慢性心力衰竭患者的运动能力及心功能 ,对慢性心力衰竭患者的康复治疗是有益的。

Objective To investigate the effect of skeletal muscle training on exercise tolerance in patients with chronic heart failure(CHF). MethodsSeventy patients with CHF were divided into group A( n =34),undergoing 3 weeks of exercise training(bicycle ergometer, treadmill walking and walking on foot),and group B( n =36), undergoing 3 weeks of activity restriction. Before and after exercise training and after activity restriction, 6 minutes of walking test was performed and levels of interleukin-6(IL-6), norepinephrine(NE) and left ventricle ejection fraction(LVEF) were evaluated. ResultsAfter exercise training in group A, the maximum distance walked was (385±30.12)m. The levels of LVEF, plasma IL-6 and NE were (43±5.23)%,(0.86±0.25)pmol/L and (2.05± 0.48 )nmol/L,respectively. All the above parameters were significantly ameliorated when compared with group B ( P <0.05 ). The above parameters were also significantly ameliorated before and after exercise training in group A, while there was no significantly change in group B( P >0.05). ConclusionThe skeletal muscle training could improve exercises tolerance and ameliorate cardiac function in patients with chronic heart failure,which was beneficial for the rehabilitative treatment.