运动疗法对慢性心力衰竭患者预后的影响

目的探讨运动疗法对行标准化治疗的慢性心力衰竭患者预后的影响。方法慢性心力衰竭患者54例随机分为运动组和对照组各27例，运动组在标准化治疗基础上进行运动训练治疗，对照组仅进行标准化治疗，随访12个月比较2组治疗效果。结果治疗前2组临床特征、NYHA心功能分级、左室射血分数、6min步行距离、血浆N末端脑钠肽、生存质量评分及药物使用率比较差异均无统计学意义（P〉0．05）；运动训练12个月后，2组左室射血分数、6min步行距离、生存质量评分、NYHA心功能分级、血浆N末端脑钠肽水平比较差异有统计学意义（P〈0．05）；运动疗法与血浆N末端脑钠肽水平较低是再住院和死亡的保护因素；室性心律失常、肾功能不全、伴有慢性肺疾病是再住院和死亡事件发生的促进因素。结论运动疗法可提高心力衰竭患者运动耐量和生活质量，改善患者心功能并明显降低死亡及再住院终点事件发生率。

Effects of exercise therapy on the prognosis in patients with chronic heart failure

Objective To observe the effect of exercise therapy on the prognosis in patients receiving standardized treatment for chronic heart failure. Methods Fifty-four patients with chronic heart failure were randomly divided into exercise group and control group, with 27 patients in each group. The exercise group received exercise therapy in addition to standardized treatment, and control group only received standardization treatment. All patients were followed up for 12 months to compare the therapeutic effect. Results There were no significant differences in clinical characteristics, NYHA classification, left ventricular ejection fraction, 6 minute walking distances, N-terminal pro-brain natriuretic peptide （NT- proBNP）, quality of life scores, and the drug use between two groups （P~〉0.05）. There were significant differences in left ventricular ejection fraction, 6-minute walking distances, quality of life scores, NYHA classification, NT-proBNP after exercise therapy for 12 months between two groups （P~0.05）. Exercise therapy and lower NT-proBNP level were the protecting factors for hospitalization and death, and ventricular arrhythmia, renal insufficiency and chronic pulmonary disease were contributory factors for re-hospitalization and deaths. Conclusion Exercise therapy can improve exercise tolerance and the quality of life for patients with chronic heart failure, improve cardiac function and reduce the incidences of death and re-hospitalization endpoint event.