运动康复训练对慢性心力衰竭患者体液因子的影响及疗效观察

目的:探讨运动康复训练对慢性心力衰竭(CHF)的疗效以及对超氧化物歧化酶(SOD)、同型半胱氨酸(Hcy)、血管紧张素Ⅱ(AngⅡ)、乳酸(LA)和脑利钠肽(BNP)形成的影响,为CHF的临床治疗提供循证医学证据。方法:依据随机数字表法将76例CHF患者分为对照组和联合组,每组38例。对照组进行常规药物治疗;联合组在对照组治疗基础上进行运动康复训练。观察2组治疗前后总有效率及各项体液因子指标的变化情况。结果:联合组患者总有效率为89.47%,对照组73.68%,联合组总有效率优于对照组(P<0.05);治疗前2组患者的心功能等级分布情况比较,差异无统计学意义(P>0.05),治疗后联合组心功能等级分布情况优于对照组,差异有统计学意义(P<0.05);治疗前2组患者血清AngⅡ、SOD、Hcy、LA及BNP水平比较,差异均无统计学意义(P>0.05);治疗后2组患者血清AngⅡ、Hcy、LA及BNP水平显著降低,SOD水平明显增高,差异均有统计学意义(P<0.05);治疗结束后,联合组患者血清AngⅡ、Hcy、LA及BNP水平降低优于对照组,差异均有统计学意义(P<0.05),联合组患者的SOD水平增高也优于对照组,差异有统计学意义(P<0.05)。结论:在常规药物治疗基础上联合运动康复训练较单纯药物治疗,能更有效调节相关体液因子,在一定程度上影响CHF患者的血管内皮功能,减少LA含量,增强心功能,疗效肯定,值得临床推广应用。

Effect of Exercise Rehabilitation Training on Humoral Factors in Patients with Chronic Heart Failure and its Effect Observation

Objective:To examine the effects of exercise rehabilitation training on chronic heart failure(CHF)and superoxide dismutase(SOD),homocysteine(Hcy),angiotensinⅡ(AngⅡ),lactic acid(LA)and the effect of brain natriuretic peptide(BNP),providing evidence-based medical evidence for the clinical treatment of CHF.Methods:A total of 76 patients with CHF were divided into control group and combination group,with 38 patients in each group,using the random number table method.The control group received routine drug therapy;the combination group received exercise rehabilitation training in addition of the control group treatment.The effective rate and the changes of various humoral factors were observed before and after treatment.Results:The total effective rate was 89.47%in the combination group while 73.68%in the control group.The total effective rate in the combination group was better than that in the control group(P<0.05).There was no significant difference in the distribution of cardiac function grades between the two groups before treatment(P>0.05).The distribution of cardiac function grades in the combination group was better than that of the control group,and the difference was statistically significant(P<0.05)after treatment.Both groups of patients before treatment the serum Ang-Ⅱ,SOD,Hcy,LA and BNP levels comparison,there were no statistically significant differences(P>0.05);After treatment in patients with serum Ang-Ⅱ,Hcy,LA and BNP levels decreased significantly,the level of SOD increased obviously,the differences were statistically significant(P<0.05).In the combination group after the treatment,the patient's serum of Ang-Ⅱ,Hcy,LA and BNP levels decreased,compared with the control group,the differences were statistically significant(P<0.05),the patient's level of SOD increased in the combination group,and was better than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with drug therapy alone,combined exercise rehabilitation training on the basis of conventional drug therapy can regulate relevant humoral factors more effectively,affect the vascular endothelial function of CHF patients to a certain extent,reduce the content of LA,enhance cardiac function,with positive curative effect,and it is worthy of clinical application.