运动干预对尿毒症合并慢性心力衰竭患者心功能的疗效分析
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Curative Effect Analysis of Exercise Intervention on Cardiac Function in Patients with Uremia Combined Chronic Heart Failure
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    目的 探讨有计划的运动干预对尿毒症合并慢性心力衰竭患者心功能的影响。方法 对86例尿毒症合并慢性心力衰竭患者,随机分为常规治疗组和运动干预组,两组患者给予等同条件的血液透析和基础治疗,常规治疗组避免任何运动干预,运动干预组另加在家步行(或慢跑)与抗阻力运动相结合的运动干预,观察疗程为10周。结果 常规治疗组NYHA心功能分级Ⅱ级患者所占比例由治疗前46.51%下降到44.19%;运动干预组NYHA心功能分级Ⅱ级患者所占比例由治疗前44.19%提高到69.77%,差异有统计学意义(P<0.05)。常规治疗组左心室射血分数(LVEF)由治疗前41.2%±6.5%提高到41.3%±7.1%;运动干预组LVEF由治疗前41.9%±7.0%提高到42.9%±6.4%,差异无统计学意义(P>0.05)。常规治疗组血清脑利钠肽(BNP)水平由治疗前1120.9±310.6 ng/L升高到1143.9±282.3 ng/L,运动干预组血清BNP水平由1083.3±294.3 ng/L下降到928.8±279.3 ng/L,差异有统计学意义(P<0.05)。结论 运动干预对合并慢性心力衰竭的维持性血液透析患者是安全的;运动干预可改善合并慢性心力衰竭的维持性血液透析患者NYHA心功能分级、血清BNP水平。

    Abstract:

    Aim To study the effect of the systematic movement intervention on cardiac function in patients with uremia combined chronic heart failure(CHF). Method 86 cases of patients with uremia combined chronic heart failure were randomly divided into conventional treatment group and exercise intervention group, which were given equivalent conditions of hemodialysis and foundation treatment. The patients in conventional treatment group avoid any exercise intervention, while in exercise intervention group, the patients were walking at home (or jogging) combined with a resistance movement of exercise intervention, which were observed for 10 weeks. Results In conventional treatment group, the proportion of Class Ⅱ patients based on NYHA heart function classification decreased from 46.51% before treatment to 44.19%, but there was no significant difference(P>0.05);After exercise treatment, the proportion of Class Ⅱ patients based on NYHA heart function classification increased from 44.19% before treatment to 69.77%, and there was significant difference(P<0.05);after treatment, there was significant difference of the proportion of Class Ⅱ patients between the two groups(P<0.05). The level of left ventricular ejection fraction (LVEF) increased from 41.2%±6.5% before treatment to 41.3%±7.1% in conventional treatment group;after ET, the level of LVEF increased from 41.9%±7.0% to 42.9%±6.4%, but LVEF before and after treatment showed no significant difference, and the difference between the two groups after treatment, had no statistical significance(P>0.05). The levels of the brain natriuretic peptide (BNP) increased from 1120.9±310.6 ng/L to 1143.9±282.3 ng/L after routine treatment, but there was no significant difference(P>0.05);after ET, the levels of the BNP decreased from 1083.3±294.3 ng/L to 928.8±279.3 ng/L, and there was significant difference(P<0.05) The difference of BNP levels after treatment between the two groups was significant (P<0.01). Conclusion Exercise intervention of merger of CHF patients with maintenance hemodialysis (MHD) is safe Exercise intervention can improve the merger of CHF patients with MHD NYHA heart function classification, the serum BNP level.

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唐东兴.运动干预对尿毒症合并慢性心力衰竭患者心功能的疗效分析[J].中国动脉硬化杂志,2013,21(12):1127~1130.

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  • 收稿日期:2013-06-13
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