抗阻训练联合有氧训练对慢性心力衰竭患者心功能和运动耐力及生活质量的影响研究

摘要

目的：探讨抗阻训练联合有氧训练对慢性心力衰竭（ CHF）患者心功能、运动耐力及生活质量的影响。方法选取2012年1月-2013年8月在佛山市中医院治疗且符合纳入和排除标准的 CHF 患者60例为研究对象，采用随机数字表法分为3组，即混合训练组、有氧训练组和对照组，每组各20例。3组均接受常规药物治疗，对照组进行日常生活活动，在此基础上，有氧训练组进行有氧训练12周，混合训练组进行抗阻训练联合有氧训练12周。于治疗前和治疗12周后对各组患者的左室舒张末期内径（ LVEDD）、左室收缩末期内径（ LVESD）、左室射血分数（LVEF）、最大耗氧量（VO2 max）、最大功率、力竭时间、6 min 步行距离测试（6MWT）结果及明尼苏达心力衰竭生活质量调查表（MLHFQ）得分进行评价和比较。结果治疗前，3组间 LVEDD、LVESD、LVEF、VO2 max、最大功率、力竭时间、6MWT 和 MLHFQ 得分各项指标比较，差异均无统计学意义（ P ﹥0.05）。治疗12周后，3组的 LVEF、VO2 max、6MWT 和 MLHFQ 得分比较，差异均有统计学意义（P ﹤0.05）；组间两两比较显示：有氧训练组、混合训练组与对照组比较，LVEF、VO2 max、6MWT 和 MLHFQ 得分间差异均有统计学意义（P ﹤0.05）；混合训练组与有氧训练组比较，LVEF 和 MLHFQ 得分间差异均有统计学意义（ P ﹤0.05），VO2 max 和6MWT 间差异均无统计学意义（ P ﹥0.05）。结论抗阻训练联合有氧训练可以改善 CHF 患者的心功能及运动耐力，进而改善患者的生活质量，为 CHF 临床治疗制定新的训练方案提供了科学依据。%Objective To compare the effects of combined resistance - aerobic training on cardiac function,maximal exercise capacity and quality of life in chronic heart failure(CHF)patients. Methods Sixty CHF patients were randomly divided into three groups:combined resistance - aerobic training( n = 20),aerobic training( n = 20),or usual care( n = 20) . Combined resistance - aerobic training group and aerobic training group trained three times per week for 12 weeks. Cardiac func-tion,including inner diameter of left ventricular end - diastole( LVEDD),inner diameter of left ventricular end - systole (LVESD),left ventricular ejection faction(LVEF),cardiopulmonary exercise testing,the 6 - minute walk test,and quality of life were measured. Results There were no significant demographic differences between groups before treatment(P ﹥ 0. 05). Both combined resistance - aerobic and aerobic training significantly improved LVEF,VO2 max,6MWT,and quality of life com-pared with usual care after treatment(P ﹤ 0. 05). Combined aerobic - resistance training significantly improved LVEF and quali-ty of life compared with aerobic training after treatment(P ﹤ 0. 05). Conclusion Both combined resistance - aerobic and aero-bic training are effective interventions to improve cardiac function and exercise endurance in CHF patients. Combined training may be more effective in improving quality of life in patients with CHF.