曹培红 孙春梅 葛卫力

[摘要] 目的 探討有氧运动对阵发性房颤（AF）射频消融术后患者左心结构、功能及运动耐力的影响。 方法 选取2018年1月至2019年2月我院心内科住院治疗的行射频消融术的阵发性AF患者110例，随机分为干预组与对照组，每组各55例。两组患者术后均行常规华法林钠片或低分子肝素等抗凝治疗。对照组患者术后给予常规干预措施，干预组患者术后3 d在对照组基础上加用有氧运动干预，两组均干预1年。观察两组术后3 d和干预1年后左心结构、功能和运动耐力指标的变化，并比较AF的复发率。 结果 干预1年后，两组LAD水平均较术后3 d明显下降，LVEF水平较术后3 d明显上升（P<0.05或P<0.01），且干预1年后干预组下降或上升幅度较对照组更显著（P<0.05）;两组患者6 min步行试验较术后3 d明显上升（P<0.05或P<0.01），且干预1年后干预组上升幅度高于对照组（P<0.05）。干预1年内，干预组患者复发4例（7.27%），对照组患者复发12例（21.82%），干预组患者的复发率明显低于对照组，差异有统计学意义（χ2=4.680，P<0.05）。 结论 有氧运动用于阵发性AF射频消融术后患者不仅可改善左心结构和功能，还可提高运动耐力，且其远期效果亦较确切，能降低其复发率。

[关键词] 房颤;射频消融术;有氧运动;左心结构;运动耐力;复发

[中图分类号] R541.7          [文献标识码] A          [文章编号] 1673-9701（2021）07-0010-03

Impacts of the aerobic exercise on left ventricular structure， function and exercise tolerance of patients with paroxysmal atrial fibrillation after radiofrequency ablation

CAO Peihong   SUN Chunmei   GE Weili

Department of Cardiology，Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University， Taizhou   317000，China

[Abstract] Objective To explore the impacts of the aerobic exercise on left ventricular structure， function and exercise tolerance of patients with paroxysmal atrial fibrillation （AF） after radiofrequency ablation. Methods From January 2018 to February 2019， a total of 110 patients with paroxysmal AF undergoing radiofrequency ablation were randomly divided into the intervention group（n=55） and the control group（n=55）. Two groups of patients were routinely anticoagulated with warfarin or low molecular weight heparin. Patients in the control group were given routine intervention measures after operation， while patients in the intervention group were given aerobic exercise intervention on the basis of the control group 3 days after operation， and both groups were intervened for 1 year. The changes of left ventricular structure， function and exercise tolerance indexes were observed three days after operation and 1 year after intervention， and the relapse rate of AF was compared between the two groups. Results After 1 year of intervention， the LAD levels of the two groups decreased significantly compared with those of 3 days after operation，and the LVEF level was significantly increased compared with that of 3 days after operation（P<0.05 or P<0.01）， and the decrease or increase range of the intervention group was more significant than that of the control group after 1 year of intervention（P<0.05）. The 6 minutes walking tests of the two groups were significantly higher than those of 3 days after operation（P<0.05 or P<0.01）， and the increase of the intervention group was more significant than that of the control group after 1 year of intervention（P<0.05）. Within 1 year of intervention， 4 patients（7.27%） in the intervention group and 12 patients （21.82%） in the control group relapsed， and the relapse rate of the intervention group was significantly lower than that of control group， with statistically significant difference（χ2=4.680， P<0.05）. Conclusion Aerobic exercise not only improves the structure and function of left heart， but also increases exercise tolerance， and its long-term efficacy is also accurate， which reduces its relapse rate.

[Key words] Atrial fibrillation; Radiofrequency ablation; Aerobic exercise; Left ventricular structure; Exercise tolerance; Relapse

房颤（Atrial fibrillation，AF）是一种常见的室上性心律失常疾病，如不及时处理，其病情常反复发作会引起左心结构和功能，影响患者的运动耐力及心功能异常[1-2]。射频消融术是目前治疗阵发性AF常用的治疗方法，具有创伤轻微、术后恢复速度快和术后并发症低等多种优点，已成为治疗AF的首选方案[3-4]。但射频消融术术后仍需进行积极康复锻炼逆转左心结构和功能异常，提高其运动耐力，改善其心功能。研究发现有氧运动对提高增强心血管系统功能具有积极的促进作用，但其用于阵发性AF射频消融术后国内外报道较少[5-6]。本研究探讨有氧运动对阵发性AF射频消融术后左心结构、功能及运动耐力的影响，现报道如下。……