[目的]探讨运动训练对老年慢性心力衰竭(CHF)患者心功能和血清胱抑素C(CysC)浓度的影响.[方法]72例心功能Ⅱ～Ⅲ级老年CHF患者随机分为训练组(n=36)和对照组(n=36),入选后即行6分钟步行试验(6MWT)、检测CysC浓度、超声多普勒检测心功能.对照组常规给予抗心衰药物治疗,在此基础上训练组每天行2次6MWT运动强度的步行训练.8周后复查6MWT、血清CysC浓度、行超声多普勒检测心功能.[结果]两组患者6MWT距离心功能Ⅲ级患者均显著短于Ⅱ级患者(P＜0.05),CysC水平Ⅲ级患者均显著高于Ⅱ患者(P＜0.05).治疗8周后两组患者血清CysC浓度均有显著下降(P＜0.05),6MWT距离明显增加(P＜0.01,P＜0.05),心功能客观指标明显提高(P＜0.05),但训练组改善程度显著优于对照组(P＜0.01).[结论]运动训练可以显著提高老年CHF患者的运动能力并降低血清CysC浓度,改善心功能.%[Objective]To explore the effect of physical training on cardiac function and serum cystatin C (CysC) level in elderly patients with chronic heart failure(CHF). [Methods] Totally 72 elderly NYHA Ⅱ ～ Ⅲ patients were randomly divided into the training group( n = 36) and the control group( n = 36). After patients were selected, the 6 minute walking test(6MWT) was performed. Serum level of CysC was determined and the cardiac function was detected by ultrasound Doppler cardiogram. The control group was treated with anti-CHF drugs. The training group was additionally given walking exercise with 6MWT exercise intensity twice a day. After 8 weeks, the 6MWT distance, serum levels of CysC and cardiac function were reexamined.[Results] The 6MWT distance of the NYHAⅢ patients was significantly shorter than that of the NYHA Ⅱ patients( P ＜0.05). Serum CysC level of the NYHAⅢ patients was significantly higher than that of NYHA Ⅱ patients( P ＜0.05). After treatment for 8 weeks, serum CysC level in both groups significantly reduced ( P ＜0.05), and the 6MWT distance and other indicators of cardiac function were significantly improved( P ＜0.01, P ＜0.05). The improvement in the training group was better than that in the control group( P ＜ 0.01). [Conclusion] Physical training can significantly improve motor ability, and reduce the serum level of CysC, and improve cardiac function of elderly patients with CHF.
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