| 沈青青,王计亮,李华伟,刘晓配,王英慧,张欣欣.吸气肌训练联合有氧训练治疗射血分数保留的心力衰竭患者的疗效研究[J].中国康复,2025,40(3):182-186 |
| 吸气肌训练联合有氧训练治疗射血分数保留的心力衰竭患者的疗效研究 |
| Efficacy of inspiratory muscle training combined with aerobic training in the treatment of patients with heart failure with preserved ejection fraction |
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| DOI：10.3870/zgkf.2025.03.011 |
| 中文关键词: 心力衰竭 射血分数保留 吸气肌训练 有氧训练 心肺功能 外周肌力 运动耐力 |
| 英文关键词: heart failure preservation of ejection fraction inspiratory muscle training aerobic training cardiopulmonary function peripheral muscle strength exercise endurance |
| 基金项目:河北省医学科学研究课题计划青年科技课题（20191836） |
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| 中文摘要: |
| 目的：研究吸气肌训练（IMT）联合有氧训练治疗射血分数保留的心力衰竭（HFpEF）患者的临床效果。方法：将我院97例HFpEF患者采用电脑随机数字表法分为对照组48例和研究组49例。2组均行规范化抗心衰药物治疗，于此基础上，给予对照组有氧训练治疗，给予研究组IMT联合有氧训练治疗。治疗前及治疗3个月后，比较2组心肺耐力指标［第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、峰值摄氧量（peakVO2)、无氧阈（AT）、6min步行距离（6 MWD）］、无创血流动力学指标［每搏输出量（SV）、心排血量（CO）、心排血指数（CI）］、外周肌力（30s椅子坐站个数）、生活质量［明尼苏达心力衰竭生活质量量表（MLHFQ）］、最大吸气压（MIP）、N末端脑钠肽前体（NT-proBNP）水平、预后情况［主要心血管不良事件（MACE）、运动后第1 分钟心率恢复、二氧化碳通气当量斜率（VE/VCO2 slope)、摄氧效率斜率（OUES)］。结果：治疗后，2组FEV1、FVC、peakVO2、AT、6 MWD高于治疗前，且研究组高于对照组（P＜0.05）；治疗后，2组CO、SV、CI高于治疗前（P＜0.01），且研究组高于对照组（P＜0.05）；治疗后2组血清NT-proBNP水平低于治疗前（P＜0.01），且研究组低于对照组（P＜0.01）；治疗3个月后，2组30s椅子坐站个数、MIP高于治疗前（P＜0.01），MLHFQ评分低于治疗前（P＜0.01），且研究组30s椅子坐站个数和MIP高于对照组（P＜0.01），MLHFQ评分低于对照组（P＜0.01）；治疗后，研究组MACE发生率、VE/VCO2slope低于对照组（P＜0.01），运动后第1分钟心率恢复、OUES高于对照组（P＜0.01，0.05）。结论：采用IMT联合有氧训练治疗HFpEF患者，能更有效促进患者心肺功能、外周肌力及运动耐力改善。 |
| 英文摘要: |
| Objective: To investigate the clinical effect of inspiratory muscle training (IMT) combined with aerobic training on patients with heart failure with preserved ejection fraction (HFpEF). Methods: A total of 97 patients with HFpEF in our hospital from January 2022 to January 2023 were selected and randomly divided into a control group and a study group using a computer-generated random number table method, with 48 cases in the control group and 49 cases in the study group. Both groups received standardized anti-heart failure drug therapy. On this basis, the control group received aerobic training therapy, while the study group received IMT combined with aerobic training therapy. The cardiopulmonary endurance indicators ［forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak oxygen uptake (peakVO2), anaerobic threshold (AT), 6 minute walk distance (6 MWD)］, non-invasive hemodynamic indicators ［stroke volume (SV), cardiac output (CO), cardiac output index (CI)］, peripheral muscle strength (number of chair sit-stands in 30 s), quality of life ［Minnesota Life Quality Heart Failure Questionnaire (MLHFQ)］, maximal inspiratory pressure (MIP), N-terminal pro-brain natriuretic peptide (NT-proBNP) level, prognosis ［major adverse cardiovascular events (MACE), heart rate recovery at 1 min after exercise, VE/VCO2 slope, OUES］ were compared between the two groups. Results: After 3 months of treatment, the FEV1, FVC, peakVO2, AT, and 6MWD in both groups were higher than those before treatment (P<0.05), and those in the study group were higher than those in the control group (P<0.05). After 3 months of treatment, the CO, SV, and CI in both groups were higher than those before treatment (P<0.05), and those in the study group were higher than those in the control group (P<0.05). After 3 months of treatment, the serum NT-proBNP levels in both groups were lower than those before treatment (P<0.05), and those in the study group were lower than those in the control group (P<0.05). After 3 months of treatment, the number of chair sit-stands in 30 s and MIP in both groups were greater than those before treatment (P<0.05), and those in the study group were higher than those in the control group, while the MLHFQ score in both groups was lower than that before treatment (P<0.05), and that in the study group was lower than that in the control group (P<0.05). After 3 months of treatment, the incidence of MACE and VE/VCO2 slope in the study group were lower than those in the control group, while the heart rate recovery at 1 min after exercise and OUES were higher than those in the control group (P<0.05). Conclusion: The treatment of HFpEF patients with IMT combined with aerobic training can more effectively promote the improvement of cardiopulmonary function, peripheral muscle strength, and exercise endurance. |
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