心脏康复训练中加入吸气肌训练对慢性心力衰竭患者吸气肌强度及心肺功能的影响  

Effects of inspiratory muscle training in cardiac rehabilitation on inspiratory muscle strength and cardiopulmonary function in patients with chronic heart failure

作　　者：陈锁芹 李爽[1,2] 陈金梅 CHEN Suo-qin;LI Shuang;CHEN Jin-mei(Department of Cardiovascular Medicine,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing Jiangsu 210029,China;Department of Cardiovascular Medicine,Nanjing Chest Hospital,Nanjing Jiangsu 210029,China)

机构地区：[1]南京医科大学附属脑科医院心血管内科,江苏南京210029 [2]南京市胸科医院心血管内科,江苏南京210029

出　　处：《临床和实验医学杂志》2023年第20期2153-2157,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省科技项目(编号:BK20211019)。

摘　　要：目的探讨心脏康复训练中加入吸气肌训练(IMT)对慢性心力衰竭(CHF)患者吸气肌强度及心肺功能的影响。方法前瞻性选取2020年7月至2022年7月南京市胸科医院收治的CHF患者98例进行研究,按随机数字表法将其分为对照组及观察组,每组各49例。对照组给予常规治疗及心脏康复训练,观察组在对照组基础上加入IMT。比较两组心肺功能[峰值氧耗量(VO_(2)peak)、无氧阈氧耗量(VO_(2)at)及二氧化碳当量斜率(VE/VCO_(2)slop)、左心室射血分数(LVEF)]、吸气肌强度[最大吸气压(MIP)、吸气峰流速(PIF)]、呼吸功能及运动耐力、炎症及心肌应激[C反应蛋白(CRP)、N末端B型利钠肽原(NT-proBNP)]水平及生活质量。结果干预后,两组VO_(2)peak、VO_(2)at及LVEF均较干预前升高,VE/VCO_(2)slop较干预前降低,观察组VO_(2)peak、VO_(2)at及LVEF均高于对照组,VE/VCO_(2)slop低于对照组,差异均有统计学意义(P<0.05)。两组MIP、PIF均较干预前上升,且观察组高于对照组,差异均有统计学意义(P<0.05)。两组Brog评分均较干预前下降,6 min步行试验(6MWD)则较干预前提高,观察组Brog评分低于对照组,6MWD高于对照组,差异均有统计学意义(P<0.05)。两组CRP、NT-proBNP水平均较干预前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。两组MLHFQ评分均较干预前升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。结论CHF患者应用心脏康复训练结合IMT治疗,可增强心肺功能,呼吸肌获得改善,且呼吸功能及运动耐力升高,炎症及心肌应激反应减轻,具有较佳生活质量。Objective To investigate the effects of inspiratory muscle training(IMT)in cardiac rehabilitation on inspiratory muscle strength and cardiopulmonary function in patients with chronic heart failure(CHF).Methods A total of 98 CHF patients admitted to Nanjing Chest Hospital from July 2020 to July 2022 were selected prospectivety.They were divided into control group and observation group according to random number table method.The control group was given routine treatment and cardiac rehabilitation training,the observation group was added IMT on the basis of control group.Cardiopulmonary function[peak oxygen consumption(VO_(2)peak),anaerobic threshold oxygen consumption(VO_(2)at),and carbon dioxide equivalent slope(VE/VCO_(2)slop),left ventricular ejection fraction(LVEF)],inspiratory muscle strength[maximal inspiratory pressure(MIP),peak inspiratory flow rate(PIF)],respiratory function,exercise endurance,inflammation myocardial stress[C-reactive protein(CRP),N-terminal pro-B-type natriuretic peptide(NT-proBNP)]levels,and quality of life were compared between the two groups.Results After intervention,VO_(2)peak,VO_(2)at and LVEF were increased in both groups,and VE/VCO_(2)slop was decreased,VO_(2)peak,VO_(2)at and LVEF in the observation group were higher than those in the control group,and VE/VCO_(2)slop was lower than those in the control group,the differences were statistically significant(P<0.05).MIP and PIF were increased in both groups,and the observation group was higher than the control group,Brog scores in both groups were decreased,but increased in 6MWD,Brog scores in the observation group was lower than that of the control group,and 6MWD was higher than that of the control group,the differences were statistically significant(P<0.05).The levels of CRP and NT-proBNP were decreased in both groups,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).MLHFQ was increased in both groups,and the observation group was higher than the control group,the diff

关 键 词：心力衰竭 心脏康复训练 吸气肌训练 吸气肌强度 心肺功能 

分 类 号：R541.6[医药卫生—心血管疾病]