CAJ | 학술논문

目的：观察运动康复训练对冠心病慢性心衰患者的治疗效果。方法：96例患者根据单双号被随机分成康复运动组和常规治疗组，各48例。康复运动组在常规治疗基础上配合运动康复训练，疗程8周。观察并比较两组患者治疗前后 NYHA 心功能分级变化、左室射血分数（LVEF）、6min 步行距离。采用酶联免疫（ELISA）法检测两组患者治疗前后血浆血管紧张素Ⅱ（AngⅡ）、内皮素-1（ET-1）含量的变化。结果：（1）治疗8周后，与常规治疗组比较，康复运动组患者 NYHA 心功能分级[（2.12±0.71）级比（1.26±0.54）级]显著改善，LVEF [（38.26±6.49）%比（47.03±5.96）%]、6min 步行距离[（390.55±40.12）m 比（501.23±44.37）m]显著提高（P ＜0.05或＜0.01）；（2）治疗后两组病人血浆 AngⅡ及 ET-1水平均显著下降，且康复运动组血浆 AngⅡ及 ET-1水平均较常规治疗组更显著下降（P ＜0.05或＜0.01）。结论：慢性心力衰竭患者进行运动康复训练可以改善心功能，降低血浆血管紧张素Ⅱ及内皮素-1水平，且安全性高。
목적：관찰운동강복훈련대관심병만성심쇠환자적치료효과。방법：96례환자근거단쌍호피수궤분성강복운동조화상규치료조，각48례。강복운동조재상규치료기출상배합운동강복훈련，료정8주。관찰병비교량조환자치료전후 NYHA 심공능분급변화、좌실사혈분수（LVEF）、6min 보행거리。채용매련면역（ELISA）법검측량조환자치료전후혈장혈관긴장소Ⅱ（AngⅡ）、내피소-1（ET-1）함량적변화。결과：（1）치료8주후，여상규치료조비교，강복운동조환자 NYHA 심공능분급[（2.12±0.71）급비（1.26±0.54）급]현저개선，LVEF [（38.26±6.49）%비（47.03±5.96）%]、6min 보행거리[（390.55±40.12）m 비（501.23±44.37）m]현저제고（P ＜0.05혹＜0.01）；（2）치료후량조병인혈장 AngⅡ급 ET-1수평균현저하강，차강복운동조혈장 AngⅡ급 ET-1수평균교상규치료조경현저하강（P ＜0.05혹＜0.01）。결론：만성심력쇠갈환자진행운동강복훈련가이개선심공능，강저혈장혈관긴장소Ⅱ급내피소-1수평，차안전성고。
Objective:To observe the therapeutic effect of exercise rehabilitation training on patients with coronary heart disease (CHD)complicated chronic heart failure (CHF).Methods:According to odd and even number,a total of 96 patients were randomly divided into rehabilitation exercise group (n=48)and routine treatment group (n=48).Rehabilitation exercise group received exercise rehabilitation training based on routine treatment for eight weeks.Changes of NYHA cardiac function class,left ventricular ejection fraction (LVEF)and 6 min walking dis-tance (6MWD)were observed and compared between two groups before and after treatment.Enzyme linked immu-nosorbent assay (ELISA)was used to measure plasma levels of angiotensin Ⅱ (AngⅡ)and endothelin-1 (ET-1)in two groups before and after treatment.Results:(1)Compared with routine treatment group after eight-week treat-ment,there was significant improvement in NYHA cardiac function [(2.12±0.71)classes vs.(1.26±0.54)clas-ses],and significant rise in LVEF [(38.26±6.49)% vs.(47.03±5.96)%]and 6MWD [(390.55±40.12)m vs. (501.23±44.37)m]in rehabilitation exercise group,P <0.05 or <0.01;(2)After treatment,plasma levels of AngⅡ and ET-1 significantly reduced in both groups,and those of rehabilitation exercise group were significantly lower than those of routine treatment group in patients with same NYHA cardiac function class,P <0.05 or<0.01.Conclusion:Exercise rehabilitation training can improve cardiac function,decrease plasma levels of angiotensin Ⅱand endothelin-1 and possess high safety in patients with chronic heart failure.