摘要
目的:探讨基于心功能分级的康复运动干预模式对慢性心力衰竭(CHF)患者的临床效果及生活质量的影响.方法:选择2021年12月至2023年1月于我院就诊的CHF患者160例,最终入组154例.根据随机数表法将患者分为研究组和对照组,每组77例.对照组采用常规护理方案,研究组在对照组基础上采用基于心功能分级的康复运动干预,两组均干预3个月.比较两组临床总有效率,干预前后的心肺功能、血清氧化应激指标及MLHFQ量表得分.结果:研究组Ⅱ级和Ⅲ级患者总有效率均显著高于对照组(Ⅱ级:100.00％比83.78％;Ⅲ级:97.37％比80.00％)(P均＜0.05).与对照组Ⅲ级患者相比,研究组Ⅲ级患者干预后peak VO2[(16.98±2.03)ml·min-1·kg-1 比(18.61±2.41)ml·min-1·kg-1]、LVEF[(41.73±4.53)％比(48.03±5.22)％]、6MWD[(351.34±61.00)m 比(391.53±64.42)m]显著升高(P 均＜0.01),而 LVEDd[(57.55±3.91)mm比(53.18±3.07)mm]、LVESd[(35.90±2.91)mm 比(30.50±2.67)mm]、LPO[(6.00±0.99)mg/L 比(3.95±0.61)mg/L]、MPO[(3.83±0.58)mg/L 比(2.03±0.28)mg/L]水平、MLHFQ 总分[(57.05±4.57)分比(45.29±3.94)分]显著降低(P均=0.001).同时与对照组Ⅱ级患者相比,研究组Ⅱ级患者干预后peak VO2、LVEF和6MWD显著升高,而LVEDd、LVESd、LPO、MPO水平和MLHFQ评分显著降低,P＜0.05或＜0.01.两组患者随访期间不良事件的发生率无显著差异(3.90％比6.49％,P=0.717).结论:采用基于心功能分级的康复运动干预CHF患者后,能够显著提高心肺功能,抑制体内氧化应激反应,改善生活质量,值得在临床上推广应用.
Abstract
Objective:To explore the impact of rehabilitation exercise intervention mode based on cardiac function classification on clinical effect and quality of life(QOL)in patients with chronic heart failure(CHF).Methods:A total of 160 CHF patients who visited our hospital from Dec 2021 to Jan 2023 were selected,and 154 cases were fi-nally enrolled.According to the random number table method,patients were divided into study group and control group with 77 cases in each group.Control group received routine nursing program,while the study group received rehabilitation exercise intervention based on cardiac function classification on the basis of control group,both groups were intervened for three months.Clinical total effective rate,and cardiopulmonary function,serum oxidative stress indicators and MLHFQ score before and after intervention were compared between two groups.Results:Total effective rates of study subgroups of class Ⅱ and Ⅲ were significantly higher than those of control group(class Ⅱ:100.00％vs.83.78％;class Ⅲ:97.37％vs.80.00％)(P＜0.05 both).Compared with control subgroup of classⅢ after intervention,there were significant rise in peak VO2[(16.98±2.03)ml·min-1·kg-1 vs.(18.61±2.41)ml·min-1·kg-1],LVEF[(41.73±4.53)％vs.(48.03±5.22)％]and 6MWD[(351.34±61.00)m vs.(391.53±64.42)m](P＜0.01 all);and significant reductions in LVEDd[(57.55±3.91)mm vs.(53.18±3.07)mm],LVESd[(35.90±2.91)mm vs.(30.50±2.67)mm],levels of LPO[(6.00±0.99)mg/L vs.(3.95±0.61)mg/L],MPO[(3.83±0.58)mg/L vs.(2.03±0.28)mg/L],and MLHFQ total score[(57.05±4.57)points vs.(45.29±3.94)points]in study subgroup of class Ⅲ(P=0.001 all).Compared with control subgroup of class Ⅱ after intervention,there were significant rise in peak VO2,LVEF and 6MWD,and significant reductions in LVEDd,LVESd,levels of LPO,MPO and MLHFQ score in study subgroup of class Ⅱ,P＜0.05 or＜0.01.There was no significant difference in the incidence rate of adverse events during follow-up between two groups(3.90％vs.6.49％,P=0.717).Conclusion:Rehabilitation exercise intervention based on cardiac function classifi-cation can significantly improve cardiopulmonary function,inhibit oxidative stress response in vivo and improve quality of life in CHF patients,which is worthy of promotion and application in clinical practice.
维普
万方数据