气体代谢运动试验指导心力衰竭病人康复治疗的效果

目的:探讨气体代谢运动试验对心衰病人康复治疗的指导价值。方法:选择纽约心脏病协会(NYHA)心功能Ⅱ～Ⅲ级病人77例进行气体代谢运动试验(气体代谢试验组),根据气体代谢运动试验结果制定康复方案,半年后复查,与既往进行常规康复治疗的NYHA心功能Ⅱ～Ⅲ级病人(常规康复组,65例)的疗效进行比较,比较两组病人心功能分级、运动时最大摄氧量(V.O2max),6min步行距离等参数。结果:与常规康复组比较,气体代谢试验组病人康复治疗半年后心功能分级无显著差异,而运动时V.O2max(22.3±7.5)ml.kg-1.min-1比(26.5±5.9)ml.kg-1.min-1],6min步行距离(315.2±25.5)m比(396.7±20.6)m]明显增加(P均<0.05)。结论:基于气体代谢运动试验结果制订的康复方案可以改善心衰病人运动功能,最大摄氧量,6min步行距离。

Effect of rehabilitation therapy by guide of gaseous metabolism exercise testing result in patients with heart failure

Objective： To investigate guidance value of gaseous metabolism exercise testing （GMET） for rehabilitation therapy in patients with heart failure. Methods： A total of 77 patients with New York heart association （NYHA） cardiac function class Ⅱ～Ⅲ underwent GMET were regard as GMET group. Rehabilitation plan was formulated according to results of GMET and their GMET were reviewed after half a year. Their NYHA cardiac function class, maximal oxygen uptake （VO2 max） during exercise and 6rain walking distance （6MWD） were compared with those of 65 patients with NYHA cardiac function class Ⅱ～Ⅲ undergoing routine rehabilitation （routine rehabilitation group）. Results： Compared with routine rehabilitation group after rehabilitation therapy half a year, there were sig- nificant increase in VO2 max during exercise（22.3 ± 7.5） ml-kg-1 . min-1 vs. （26.5 ± 5.9） ml-kg- 1 . min-1 3 and 6MWD - （315.2 ± 25.5） m vs. （396. 7 ± 20.6） m] in GMET group, P〈0.05 both. There was no significant differ- ence in NYHA cardiac function class between two groups （P〉0.05）. Conclusion： Rehabilitation plan under guidance of gaseous metabolism exercise testing result can improve exercise function, maximal oxygen uptake during exercise and 6min walking distance in patients with heart failure.