康复训练对老年冠心病慢性心力衰竭患者心功能及预后的影响  

Influence of Rehabilitation Training on Cardiac Function and Prognosis in Aged Patients with Coronary Heart Disease and Chronic Cardiac Failure

作　　者：邓锦清[1] 刘泽[2] 郭振辉[3] 戴波[4] 

机构地区：[1]广州军区广州总医院华侨科,广州市510010 [2]广州军区广州总医院老年病科,广州市510010 [3]广州军区广州总医院MICU科,广州市510010 [4]广州军区广州总医院心血管内科,广州市510010

出　　处：《广西医学》2014年第8期1093-1095,共3页Guangxi Medical Journal

摘　　要：目的探讨康复训练对老年冠心病慢性心力衰竭(CHF)患者心功能及预后的影响。方法将142例老年冠心病CHF患者随机分为两组,每组71例,对照组采用常规药物治疗同时进行健康教育,观察组在常规药物治疗基础上采用康复运动训练。比较两组患者治疗前后左室射血分数(LVEF)、左室舒张期内径(LVD)、心脏功能分级、血浆脑钠肽(BNP)含量和6 min步行实验距离。两组均随访12个月,比较再次因CHF住院率和死亡率。结果治疗后两组LVEF和6 min步行实验距离均增加,观察组增加幅度大于对照组(P<0.01);LVD、心功能分级及血浆BNP含量均降低,观察组降幅大于对照组(P<0.01)。对两组患者随访12个月,随访期间再次因CHF住院率观察组低于对照组(P<0.05),两组死亡率比较,差异无统计学意义(P>0.05)。结论在药物治疗基础上进行康复训练可改善老年冠心病CHF患者的心脏功能,提高运动耐力,降低再次CHF住院率。Objective To investigate the effect of rehabilitation training on cardiac function and prognosis in elderly patients with coronary heart disease and chronic heart failure （ CHF ） .Methods One hundred and forty-two elderly patients with coronary heart disease and CHF were randomly divided into two groups , with 71 cases in each group .The control group was treated with routine medicine and health education ,while the observation group was treated with rehabilitation training combined with routine medicine .The left ventricular ejection fraction （LVEF）,left ventricular diastolic diameter（LVD）,cardiac function classification ,plasma brain natriuretic peptide （BNP） content and 6-minute walking distance （ 6MWD ） before and after treatment were measured in two groups .The 12-month follow-up was performed for all patients to compare re-hospitalization rate and mortality for CHF .Results The observation group showed increased LVEF and 6MWD compared with control group ,the increase in the observation group was more than that in the control group （ P 〈0.01 ） .lower LVDs , cardiac function classification and plasma BNP content were observed , and the decrease in the observation group was more than that in the control group （P〈0.01）.The observation group had significantly lower re-hospitalization rate during the 12-month follow-up period（P〈0.05）.There was no significant difference in the mortality between two groups（P〉0.05）.Conclusion The rehabilitation training based on the routine medication could improve the cardiac function ,the enhance endurance of exercise and decrease the re-hospitalization rate in elderly patients with coronary heart disease and CHF .

关 键 词：冠心病 心力衰竭 康复训练 老年 心脏功能 

分 类 号：R541.4[医药卫生—心血管疾病]