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中国应用生理学杂志 ›› 2015, Vol. 31 ›› Issue (4): 374-377.doi: 10.12047/j.cjap.0124.2015.019

• 研究论文 • 上一篇    下一篇

心肺运动指导个体化心衰患者康复的初步总结报告*

刘艳玲1, 孙兴国1,2,△, 高华1, 张振英1, 冯静1, 姜立清1, 张健2, 席家宁1, 周京敏3, 葛万刚2   

  1. 1.首都医科大学附属北京康复医院 心肺康复中心, 北京 100144;
    2.中国医学科学院 北京协和医学院 国家心血管病中心阜外医院 心血管疾病国家重点实验室, 心血管疾病国家临床医学研究中心,北京 100037;
    3.复旦大学中山医院心脏中心,上海200032
  • 收稿日期:2015-06-05 修回日期:2015-07-05 发布日期:2021-11-12
  • 通讯作者: Tel: 010-88398300, E-mail: xgsun@labiomed.org
  • 基金资助:
    *国家自然科学基金医学科学部面上项目(81470204); 国家高新技术研究发展计划(863计划)课题(2012AA021009); 中国医学科学院国家心血管病中心科研开发启动基金(2012-YJR02); 北京市首都特色科研项目(Z141107002514084)

Preliminary report of using cardiopulmonary exercise testing guide exercise rehabilitation in patients with chronic heart failure

LIU Yan-ling1, SUN Xing-guo1, GAO Hua1, ZHANG Zhen-ying1, FENG Jing1, JIANG Li-qing1, ZHANG Jian2, XI Jia-ning1, ZHOU Jing-min3, GE Wan-gang2   

  1. 1. CardioPulmonary Rehabilitation Center,Beijing Rehabilitation Medical Center, Capital Medical University,Beijing 100144;
    2. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Research Center of Clinic Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China;
    3. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 20032, China
  • Received:2015-06-05 Revised:2015-07-05 Published:2021-11-12

摘要: 目的: 慢性心力衰竭患者(CHF)康复治疗和二级预防已经是临床共识,但用心肺运动试验(CPET)指导制定个体化运动处方国内尚少。方法: 选择10例CHF完成CPET评估,随机分为两组(n=5):对照组进行没有运动;运动组增加△50%W功率运动30 min/d,每周5 d,共12周。在治疗前和3个月后分别进行评估。结果: 两组患者没有显著差异(P>0.05)。运动组12周后,运动持续时间从8 min显著提高到23 min(P<0.001); 6分钟步行距离从394 m显著提高到470 m(P<0.05);生活质量评分从25分显著降低至3分(P<0.01)。而对照组治疗前后均没有显著改变(P>0.05);治疗前后的改变均显著小于运动组(P<0.01)。结论: 在CPET客观定量功能评估指导制定个体化高强度运动康复安全有效,值得大力推广应用。

关键词: 心肺运动试验, 客观定量评估, 慢性心力衰竭, 康复运动处方, 恒定功率运动, 运动持续时间, 6分钟步行距离, 生活质量评分

Abstract: Objective: The exercise rehabilitation in patient with chronic heart failure (CHF) is standard clinical practice,but it is rare using CardioPulmonary Exercise Testing (CPET) guide to prescribe exercise rehabilitation in China. Methods: We performed symptom limited maximal CPET in 10 patients with CHF, randomly divided into two groups: 5 patients as control without exercise and 5 exercise patients usedΔ50%W intensity to exercise 30 min/d,5 d/w,×12 w. Before and after 12 w rehabilitation, we evaluated functions. Results: There were no significant difference between two groups patients (P>0.05).The exercise duration was increased from 8 min to 23 min after rehabilitation (P<0.001); distance 6 minutes walking was increased from 394 m to 470 m (P<0.05); score of Minnesota quality of life was decreased from 25 to 3 in exercise group (P<0.01). However, there were nosignificant changes in control group (P>0.05) and their changes were smaller than those in exercise group (P<0.01). Conclusion: The CPET guiding exercise rehabilitation is safe and effective for patients with CHF.

Key words: cardiopulmonary exercise testing, objective and qualitative evaluation, chronic heart failure, rehabilitation loading, constant work rate exercise, continuous exercise duration, 6 min walking distance, quality of life

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