早期运动干预对重度心力衰竭患者生活质量的影响

目的：探讨早期运动干预对重度心力衰竭（心功能Ⅳ级）患者生活质量的影响。方法：200例重度心力衰竭患者被随机均分为常规治疗组和观察组（在常规组药物治疗基础上采用早期运动治疗）。观察入院时、3周、6个月后患者血压和静息心率、6min步行距离、生活质量、左心室射血分数（LVEF）等的变化。结果：6个月后,与常规治疗组比较,观察组患者静息心率明显下降[（107.3±15.8）次/min∶（75.8±9.4）次/min],6min步行距离明显延长[（324.3±110.5）m∶（478.1±113.3）m],LVEF明显增加[（33.5±8.7）%∶（48.9±9.3）%],心功能明显改善（心功能转为II级人数明显增多,28.09%∶84.69%）;随访期间再次心衰住院率（29.67%∶9.18%）和总住院率（42.86%∶22.45%）明显降低（P均〈0.01）,且上述指标较干预前明显改善（P均〈0.01）,而常规组干预前后无显著差异。观察组2例（2%）死于心源性猝死,显著少于常规治疗组的9例（9%,因肺部感染、心血管事件而心衰加重死亡）,P〈0.05。结论：早期运动干预对提高重度心力衰竭患者生活质量和促进心脏功能康复是安全有效的。

Effects of early exercise intervention on quality of life in patients with severe heart failure

Objective： To explore effects of early exercise intervention on quality of life in patients with severe heart failure（NYHA cardiac function class Ⅳ）.Methods： A total of 200 cases with severe heart failure were involved and randomly averagely divided into routine treatment group and observation group（received early exercise treatment based on routine treatment）.The heart rate,blood pressure,6-minute walking distance,quality of life and left ventricular ejection fraction（LVEF） were observed and analyzed between two groups.Results： Compared with routine treatment group after six months,resting heart rate [（107.3±15.8） time/min vs.（75.8±9.4） time//min] significantly decreased;6-minute walking distance [（324.3±110.5）m vs.（478.1±113.3）m],LVEF [（33.5±8.7）% vs.（48.9±9.3）%] significantly increased;cardiac function significantly improved（number of patients improved to NYHA class II significantly increased,28.09% vs.84.69%）;rehospitalization rate（29.67% vs.9.18%） caused by heart failure and total admission rate（42.86% vs.22.45%） significantly decreased in observation group,P0.01 all.All above indexes in observation group significantly improved compared with before intervention（P0.01 all）,but there was no significant difference before and after intervention in routine treatment group（P0.05）.The mortality of observation group was of 2%,and was less than that of routine treatment group（9%）（P0.05）.Conclusion： Early exercise intervention is effective and safe to improve quality of life and promote rehabilitation of cardiac function in patients with severe heart failure.