从多维度分析基于心功能分级的运动康复训练在老年慢性心力衰竭患者中的应用价值  

Application value of exercise rehabilitation training based on cardiac function in elderly patients with chronic heart failure from multiple dimensions

作　　者：周丽军[1] Zhou Lijun(Department of Rehabilitation Medicine,Handan First Hospital,Handan 056004,Hebei Province,China)

机构地区：[1]邯郸市第一医院康复医学科,河北邯郸056004

出　　处：《中华老年多器官疾病杂志》2025年第3期197-201,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：河北省医学科学研究课题(20210232)。

摘　　要：目的探讨运动康复训练在老年慢性心力衰竭(CHF)患者中的应用效果。方法选择邯郸市第一医院康复医学科2020年1月至2022年1月收治的190例老年CHF患者为研究对象,根据随机数表法将患者分为运动组及对照组,每组各95例。对照组患者接受常规干预,运动组在常规干预基础上联合运动康复训练。干预3个月后,观察两组患者心理情绪状况、心力衰竭症状、心功能、心肌代谢水平、血压、血糖、血脂水平及生活质量情况。采用SPSS 23.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ2检验进行组间比较。结果运动组中共78例患者顺利完成运动康复训练、随访及相关调查,对照组共89例患者完成随访及相关调查。运动组干预3个月后,其焦虑自评量表(SAS),抑郁自评量表(SDS),老年心理状态量表(GMS)中消极影响维度得分,Memorial心力衰竭症状评估量表(MSAS-HF)中气短、腿胳膊水肿、头晕、心悸等心力衰竭症状严重程度得分,血浆氨基末端脑钠肽前体(NT-proBNP),心肌能量消耗(MEE),左心室收缩末圆周室壁应力(cESS),收缩压(SBP),糖化血红蛋白(HbA1c)及低密度脂蛋白胆固醇(LDL-C)水平均较干预前降低,且均低于对照组干预后水平;左室射血分数(LVEF)及明尼苏达心力衰竭生活质量量表(MLHFQ)较干预前升高,且均高于对照组干预后水平,差异均有统计学意义(P<0.05)。结论基于心功能分级的运动康复训练能有效改善老年CHF患者不良心理情绪状态、减轻心力衰竭症状,改善心肌能量代谢障碍,提高LVEF,同时有利于患者血压、血糖及血脂代谢的控制,进而提高生活质量。Objective To explore the application effect of exercise rehabilitation training in elderly patients with chronic heart failure(CHF).Methods A total of 190 elderly CHF patients admitted to the Department of Rehabilitation Medicine of Handan First Hospital from January 2020 to January 2022 were selected as the study subjects.The patients were divided into an exercise group and a control group(95 in each group)using random number table method.The control group received conventional intervention,and the exercise group received exercise rehabilitation training on the basis of conventional intervention.After three months of intervention,the psychological and emotional status,heart failure symptoms,cardiac function,myocardial metabolism,blood pressure,blood glucose,blood lipids,and quality of life were observed in both groups.Data analysis was performed using SPSS 23.0,and t test or Chi-square test was performed according to the data type.Results In the exercise group,78 patients successfully completed exercise rehabilitation training,follow-up and related investigations,and 89 patients in the control group completed follow-up and related investigations.After three months of intervention in the exercise group,the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),negative impact dimension of geriatric mental state scale(GMS),and the severity scores of heart failure symptoms such as shortness of breath,leg and arm edema,dizziness and palpitation in the memorial symptom assessment scale-heart failure(MSAS-HF),N-terminal pro-brain natriuretic peptide(NT-proBNP),myocardial energy expenditure(MEE),circumferential end-systolic wall stress(cESS),systolic blood pressure(SBP),glycosylated hemoglobin(HbA1c)and low-density lipoprotein cholesterol(LDL-C)were all lower than those before intervention,and were lower than those in control group after intervention;the left ventricular ejection fraction(LVEF)and Minnesota living with heart failure questionnaire(MLHFQ)were higher than those before intervention,and

关 键 词：老年人 慢性心力衰竭 运动康复训练 生活质量 

分 类 号：R592[医药卫生—老年医学] R473.5[医药卫生—内科学]