何峰 曹俊达 李江涛

[摘要] 目的 探讨有氧康复运动联合个性化康复治疗对慢性心力衰竭（CHF）患者疗效及血清炎症因子的影响。 方法 选取2016年1月至2019年8月九江市第一人民医院心血管内科62例CHF患者为研究对象，随机分为研究组（n=31）和对照组（n=31），分别在完成常规临床抗心力衰竭治疗病情稳定后展开康复治疗。采用MoCA、HAMA量表、HAMD量表评价两组患者治疗前后得分及疗效，同时测定治疗前后血清TNF-α、IL-6、CRP水平及LVEF水平。结果 干预后研究组MoCA评分、LVEF高于对照组，HAMA评分、HAMD评分低于对照组，差异有统计学意义（P<0.05）;干预前两组血清TNF-α、IL-6和CRP水平比较，差异无统计学意义（P>0.05），但干预后研究组血清TNF-α、IL-6和CRP水平较对照组患者均显著下降，差异有统计学意义（P<0.05）。 结论 有氧运动对CHF患者机体功能具有显著改善作用，在其基础上联合个性化康复治疗能够进一步提高CHF患者的疗效，提高患者生活质量，并显著降低血清炎症因子水平。

[关键词] 有氧康复运动;个性化康复;慢性心力衰竭;炎症因子

[中图分类号] R54          [文献标识码] B          [文章编号] 1673-9701（2021）34-0089-03

[Abstract] Objective To investigate the effect of aerobic rehabilitation exercise combined with individualized rehabilitation on the efficacy and serum inflammatory factors in patients with chronic heart failure（CHF）. Methods A total of 62 patients with CHF in the Jiujiang NO.1 People′s Hospital from January 2016 to August 2019 were randomly divided into study group（n=31） and control group（n=31）. MoCA， HAMA scale and HAMD scale were used to evaluate the scores and efficacy of the two groups before and after treatment. The serum TNF-α， IL-6， CRP， and LVEF levels were also measured before and after treatment. Results After the intervention， MoCA score and LVEF of the study group were higher than those of the control group， while HAMA score and HAMD score were lower than those of the control group， and the differences were statistically significant （P<0.05）. There was no significant difference in the serum TNF-α， IL-6， and CRP levels between the two groups before rehabilitation treatment （P>0.05）. But the serum TNF-α， IL-6， and CRP levels in the study group were significantly lower than those in the control group after rehabilitation treatment， and the differences were statistically significant （P<0.05）. Conclusion Aerobic exercise can significantly improve the function of patients with CHF. Based on it， individualized rehabilitation therapy can further promote the efficacy of patients with CHF， improve the quality of life of patients， and significantly reduce serum inflammatory factors.

[Key words] Aerobic rehabilitation exercise; Individualized rehabilitation; Chronic heart failure; Inflammatory factors

慢性心力衰竭（Chronic heart failure，CHF）是各類心脏疾病的终末阶段，表明心排血量已满足不了患者机体的需要。随着人口老龄化及心血管疾病的多发，CHF的发病率将进一步增高[1]。由于CHF即使缓解也可以反复多次的发作，严重影响患者的身体健康及生活质量。而有氧康复运动可以在生理和心理两个方面改善CHF患者的症状和预后，提高心力储备，改善患者生活质量。但是目前对于CHF患者康复运动比较单一，未能根据患者心脏功能及其他个体情况进行个性化定制，效果并不显著[2-3]。并且，炎症反应在CHF的全过程中都具有重要的作用，但是目前临床上对CHF的各种康复方案对患者体内炎症过程及炎症因子的影响的研究较少。鉴于此，本研究主要探讨有氧康复运动联合个性化康复治疗对CHF患者疗效及血清炎症因子的影响，现报道如下。……