运动训练对充血性心力衰竭患者白细胞的影响

目的 探讨六分钟步行运动训练(6-minute walk test,6-MWT)治疗充血性心力衰竭患者的价值,对不同程度充血性心力衰竭(Congestive heart failure,CHF)患者白细胞的影响及分类的影响。方法 60例Ⅱ～Ⅲ级心功能充血性心衰患者在入院24h之内作6-MWT,记录其行步距离,静息状态和运动后心率。然后随机分为两组(训练组32例,对照组28例),均行常规抗心衰药物治疗,但训练组行6-MWT,2次/d,8周后重复检测上述指标。对23例Ⅳ级心功能CHF患者观察了入院时白细胞及分类的变化。结果 运动训练可显著改善CHF征象,减慢增快的心率,增加行走距离,训练组与对照组存在显著性差异(P<0.05)。Ⅲ～Ⅳ级CHF患者白细胞总数中性粒细胞和单核细胞比例比Ⅱ级CHF患者明显增高,且其差异非常显著(P<0.01);运动训练组治疗8周后,CHF患者增高的白细胞、中性粒细胞和单核细胞比例,与对照组相比较,下降非常显著(P<0.05或P<0.01)。结论 运动训练加药物治疗8周后心力衰竭患者静息状态下血白细胞总数、单核细胞比单纯药物治疗组明显降低,提示运动训练可明显改善心衰患者的征象,提高运动耐力。

The effect of exercise training on blood leucocyte in patients with congestive heart failure

Objective To detect the value of "6-minute walk test"(6-MWT) on treatment of congestive heart failure (CHF) and the effect of exercise training on blood leucocyte and its classification of CHF patients. Methods The 60 cases with NYHA Ⅱ - Ⅲ grade were performed 6-MWT within 24 hours after admitted into the hospital. The walking distance, heartbeat, blood leucocyte and its classification were investigated before and after the walking test. Then, these patients were divided into two groups random: training group (32 cases) and control group (28 cases). Besides routine drugs, 6-MWT was performed in training group twice a day for 8 weeks. The same parameters were re-determined after 8 weeks follow-up. The leucocyte and its classification of 23 cases with NYHA IV grade were investigated in the first day after admitted into the hospital. Results There were significant difference in reducing heartbeat and extending walking distance before and after exercise training. Blood leucocyte, percentage of neutrophil and mononuclear cell in cases with NYHA Ⅲ - Ⅳ grade were significantly higher than those in cases with NYHA Ⅱ grade. Blood leucocyte and the percentage of neutrophil and mononuclear cell reduced more in training group than in control group after being treated for 8 weeks. Conclusion The total leucocyte count and the percentage of neutrophil and mononuclear cell of CHF with NYHA Ⅲ -Ⅳ grade is significantly higher than those with NYHA Ⅱ grade. 6-MWT, as an exercise training, is simple, sale, and less harmful, by which not only the severity of CHF could be evaluated but also the therapy of CHF could be added.