本文選題：運(yùn)動(dòng)康復(fù)　切入點(diǎn)：射血分?jǐn)?shù)保存心力衰竭　出處：《臨床心血管病雜志》2017年09期 　論文類型：期刊論文

【摘要】：目的:探討運(yùn)動(dòng)康復(fù)治療對(duì)射血分?jǐn)?shù)保存心力衰竭(心衰)患者運(yùn)動(dòng)耐力、舒張功能和生活質(zhì)量的影響。方法:入選了100例NYHA心功能Ⅱ~Ⅲ級(jí),左室射血分?jǐn)?shù)(LVEF)保存心衰患者,在藥物治療基礎(chǔ)上,根據(jù)患者意愿分為運(yùn)動(dòng)康復(fù)組和對(duì)照組。運(yùn)動(dòng)康復(fù)組采用踏車運(yùn)動(dòng)康復(fù),訓(xùn)練強(qiáng)度為基線水平癥狀限制性心肺運(yùn)動(dòng)試驗(yàn)測(cè)得的峰值氧耗量(peak VO_2)50%~80%。每周運(yùn)動(dòng)3次,每次40min。在基線及12周隨訪結(jié)束時(shí)通過(guò)心肺運(yùn)動(dòng)試驗(yàn)測(cè)peak VO_2,二氧化碳通氣當(dāng)量斜率(VE/VCO2slop),無(wú)氧閾氧耗量(VO_2AT),最大運(yùn)動(dòng)功率和最大運(yùn)動(dòng)時(shí)間;超聲心動(dòng)圖儀檢測(cè)并計(jì)算舒張?jiān)缙诙獍暄魉俣扰c舒張?jiān)缙诙獍戥h(huán)運(yùn)動(dòng)速度比(E/e'),左房容積指數(shù)(LAVI),左室肌重量指數(shù)(LVMI),LVEF;測(cè)試6 min步行距離;測(cè)血漿N端B型腦鈉肽前體(NTproBNP);通過(guò)明尼蘇達(dá)心衰生活質(zhì)量問(wèn)卷表(MLWHFQ)評(píng)估生活質(zhì)量。并對(duì)上述指標(biāo)進(jìn)行組內(nèi)及組間比較。結(jié)果:運(yùn)動(dòng)康復(fù)組及對(duì)照組隨訪12周后peak VO_2、VO_2AT、最大運(yùn)動(dòng)功率、最大運(yùn)動(dòng)時(shí)間及6min步行距離均較前增加(P0.05);VE/VCO2slop、E/e'、LAVI及MLWHFQ總分均較前下降(P0.05),但運(yùn)動(dòng)康復(fù)組優(yōu)于對(duì)照組(P0.05)。LVMI、LVEF及NT-proBNP組內(nèi)比較及組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:運(yùn)動(dòng)康復(fù)治療改善了LVEF保存心衰患者的運(yùn)動(dòng)耐力、左室舒張功能及生活質(zhì)量。
[Abstract]:Objective: to investigate the effects of exercise rehabilitation therapy on exercise endurance, diastolic function and quality of life in patients with heart failure (HF) preserved by ejection fraction. On the basis of drug therapy, the patients were divided into two groups according to their wishes: exercise rehabilitation group and control group. The intensity of training was the peak oxygen consumption measured by the restricted cardiopulmonary exercise test at baseline level and 80 times a week. At the end of baseline and 12 weeks follow-up, peak VO _ 2 was measured by cardiopulmonary exercise test, V / V _ 2O _ 2slopa, oxygen consumption at anaerobic threshold, maximal exercise power and maximal exercise time. The ratio of mitral annular velocity to mitral annular velocity was measured by echocardiography, left atrial volume index (LVMIV), left ventricular mass index (LVMI) and left ventricular mass index (LVEF) were measured, and 6 min walking distance was measured. The plasma N-terminal B-type brain natriuretic peptide precursor (NTproBNPN) was measured, and the quality of life (QOL) was evaluated by the Minnesota Heart failure questionnaire (MLWHFQ). The above indexes were compared within and between groups. Results: peak was followed up 12 weeks after 12 weeks follow-up in the exercise rehabilitation group and the control group. Vo2s / Vo2ATs, maximum moving power, The maximal exercise time and 6-minute walking distance increased P0.05V / VCO _ 2slop-E / E / E / P _ (0.05), but the total scores of exercise rehabilitation group were better than that of control group (P _ (0.05)). LVMI / LVEF and NT-proBNP had no significant difference (P _ (0.05)). Conclusion: exercise rehabilitation therapy is improved. Good LVEF preserves the exercise endurance of patients with heart failure, Left ventricular diastolic function and quality of life.
【作者單位】： 云南省第一人民醫(yī)院心內(nèi)科;
【分類號(hào)】：R541.6

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