慢性心力衰竭患者标准有氧训练与组合式训练的效果比较

目的：比较标准有氧呼吸训练(AT)与组合式(ARI)训练在慢性心力衰竭患者康复治疗中的效果差异。方法纳入27个慢性心力衰竭患者,所有患者分配至 AT 训练组(n=14,12周)和 ARI 训练组(n=13,12周)。两组各自训练12周,在训练开始前和结束时对呼吸肌的最大强度(PImax)、股四头肌肌力(QME)、四头肌力矩的峰值(QMTpeak)、一次所能承受的最大负荷(1RM)、训练时间、尼苏达生活质量问卷调查表(MLwHFQ)、Borg scale 评分表等各项参数进行评定。结果参与 ARI 组的患者的各项下肢及呼吸肌指标明显优于 AT 组的患者(P <0.05)。ARI 组相比运动训练前的各项指标差异有统计学意义(P <0.05)。AT 组患者运动前后比较,仅 QME 和 PImax 差异有统计学意义(P <0.05)。两组患者 Peak VO2、训练时间、VT 都有显著提高,而 ARI 组患者的 VE/VCO2 slope、SBPpeak 和 CP 也得到改善。进一步分析表明,在 ARI 组中患者训练时间明显长于AT 组患者(P =0.01)。ARI 组训练后的超声心动图参数较训练前有显著性改善(P <0.05)；AT 组患者仅左室射血分数(LVEF)和左室收缩末期内径(LVESD)比较差异有统计学意义(P <0.05)。ARI 组的 MLwHFQ、Borg scale 评分均优于 AT 组(P <0.05),且仅 ARI 组的 MLwHFQ 和 NYHA 训练后得到改善(P <0.05)。结论ARI 训练方式可以使外周和呼吸肌的功能得到显著增强、心肺功能和生活质量得到明显改善。

A comparison of rehabilitation effection between standard the effect of standard aerobic training and combined aerobic training on patients with chronic heart failure

Objective To compare the rehabilitation effection between standard aerobic training and combined aerobic train-ing in patients with chronic heart failure.Methods Eligible 27 patients with chronic heart failure were collected and divided into two groups:AT group (standard aerobic training)and ARI group (combined aerobic training).Then two groups underwent differ-ent trainings in 12 weeks respectively.Various indexs such as PImax,QME,QMTpeak ,1RM,exercise time,MLwHFQ,and Borg Scale was analyzed before and after the training.Results QMTpeak ,IRM,QME,PImax and SPImax in ARI group were better than those in AT group(P <0.05).And all these index of ARI group also developed compared with before the training(P <0.05),while in AT group,only QME and PImax changed(P <0.05).Both group′s Peak VO2 ,excrcise time,VT increased significantly,and VE/VCO2 slope、SBPpeak and CP of them improved.Compared with AT group,the exercise time of ARI group was longer(P =0.01 ). The echocardiographic parameters of ARI group improved after training(P <0.05),while only LVEF and LVESD had significant different in AT group(P <0.05).MLwHFQ,Brog scale score of ARI group were better than those in AT group.And only MLwH-FQ NYHA in ARI group improved after training(P <0.05).Conclusion The strength of the upper limb and respiratory muscle cardiopulmonary function,and quality of life have been improved markedly in ARI group.