中国全科医学2016，Vol.19Issue(35)：4302-4309,8.DOI:10.3969/j.issn.1007-9572.2016.35.004
心肺运动试验制定运动强度对慢性心力衰竭患者心脏运动康复治疗效果影响的临床研究
Effects of Exercise Intensity Eeduced from Cardiopulmonary Exercise Testing on Exercise Rehabilitation Efficacy among Patients with Chronic Heart Failure:A Clinical Study
摘要
Abstract
Objective To investigate the effects of exercise rehabilitation( ER)on cardiopulmonary function and quality of life(QoL)among patients with chronic heart failure( CHF),and to explore exercise rehabilitation efficacy under different exercise intensity. Methods 15 patients who were diagnosed with CHF in Beijing Rehabilitation Hospital of Capital Medical University from September 2014 to May 2016,were recruited and randomly divided into three groups:patients in control group(n = 5)were treated with conventional therapy without exercise,the overall function of patients in moderate exercise load group(ML group,n = 5)and high exercise load group( HL group,n = 5)were evaluated objectively and quantitatively by using cardiopulmonary exercise testing( CPET),and patients in these two groups underwent ER according to individualized moderate intensity exercise prescription(30 min/ day,5 days/ week,lasted for 12 weeks),patients in ML group exercised using 80% anaerobic threshold( AT)intensity of cycle ergometer,patients in HL group exercised using exercise intensity ofΔ50% power above AT. General information,CPET results,echocardiogram results,6 minute walking distance(6MWD)and QoL score of three groups were recorded respectively before and after treatment. Results All patients finished symptom limited extreme exercise CPET safely without complications,patients in ML and HL group finished 12 - weeks ER. Before treatment, there were no significant difference in AT,peak oxygen uptake,peak oxygen pulse,peak load power,echocardiogram results, 6MWD and QoL score among three groups(P > 0. 05). After treatment,AT(ml/ min,ml·min - 1 ·kg - 1 ),peak load power (% pred)and 6MWD of patients in ML group were significantly higher than those of patients in control group,QoL score of patients in ML group was significantly lower than that of patients in control group( P < 0. 05). AT( ml/ min,ml·min - 1 · kg - 1 ),peak oxygen uptake(ml/ min,ml·min - 1 ·kg - 1 ,% pred),peak oxygen pulse( ml/ time),peak load power( W,% pred)and 6MWD of patients in HL group were significantly higher than those of patients in control group,QoL score of patients in HL group was significantly lower than that of patients in control group( P < 0. 05). AT( ml/ min,ml·min - 1 · kg - 1 ),peak oxygen uptake(ml/ min,ml·min - 1 ·kg - 1 ,% pred)and peak oxygen pulse(ml/ time)of patients in HL group were significantly higher than those of patients in ML group(P < 0. 05). There were no significant difference in CPET indexes, echocardiogram results,6MWD and QoL score in control group between before and after treatment(P > 0. 05). AT(ml/ min, ml·min - 1 ·kg - 1 ,% pred),peak load power(W,% pred),left ventricular ejection fraction(LVEF),6MWD and QoL score of patients in ML group after treatment were significantly higher than those before treatment,QoL score of patients in ML group after treatment was significantly lower that before treatment( P < 0. 05). AT( ml/ min,ml·min - 1 ·kg - 1 ,% pred),peak oxygen uptake( ml/ min,ml · min - 1 · kg - 1 ,% pred),peak oxygen pulse( ml/ time,% pred),peak load power( W,%pred),LVEF and 6MWD of patients in HL group after treatment were significantly higher than those before treatment,QoL score of patients in HL group after treatment was significantly lower than that before treatment( P < 0. 05). Conclusion ER can improve the cardiopulmonary function,exercise tolerance and QoL of CHF patients significantly,high - load ER is more effective in improving cardiopulmonary function safely.关键词
心力衰竭/心肺运动试验/康复/治疗结果Key words
Heart failure/Cardiopulmonary exercise testing/Rehabilitation/Treatment outcome分类
医药卫生引用本文复制引用
张振英,孙兴国,席家宁,刘艳玲,冯静,姜立清,高华..心肺运动试验制定运动强度对慢性心力衰竭患者心脏运动康复治疗效果影响的临床研究[J].中国全科医学,2016,19(35):4302-4309,8.基金项目
国家高技术研究发展计划（863计划）课题（2012AA021009）；国家自然科学基金医学科学部面上项目（81470204）；中国医学科学院国家心血管病中心阜外医院科研开发启动基金（2012- YJR02）；首都临床特色应用研究（Z141107002514084）；首都临床特色应用研究与成果推广 （）
