摘要
目的探讨医院-社区-家庭一体化心脏康复模式对射血分数保留型心力衰竭(heart failure with preserved ejection fraction,HFpEF)患者心肺功能的改善效果。方法选取本院2018年6月至2019年6月心内科收治的116例HFpEF患者,按随机数字表法分为对照组和观察组各58例。对照组患者予以常规慢性心力衰竭治疗与护理,观察组在此基础上采用医院-社区-家庭一体化心脏康复模式进行干预管理。比较两组患者康复前后心肺储备功能、6分钟步行距离(6MWT)、血清中N末端B型利钠肽原(NT-pro BNP)水平和肿瘤坏死因子α(TNF-α)、白介素-1β(IL-1β)、一氧化氮(NO)水平变化,评估康复效果。结果康复干预1年后,两组患者心肺运动实验指标peak VO2、VO2 AT以及6MWD水平均较康复干预前升高,且观察组高于对照组(P<0.05);两组患者心功能指标LAVI、NT-pro BNP以及炎性指标TNF-α、IL-1β均较干预前降低,且观察组低于对照组(P<0.05)。结论医院-社区-家庭一体化心脏康复模式较常规慢性心力衰竭治疗与护理更有利于HFPEF患者的心肺储备功能的恢复和患者炎症水平的降低,预后更好,值得临床推广。
Objective To investigate the improvement effect of hospital-community-home integrated cardiac rehabilitation for cardiopulmonary function in patients with heart failure with preserved ejection fraction(HFpEF).Methods From June 2018 to June 2019,116 patients with HFpEF were randomly divided into a control group and an observation group,58 in each group.The control group was given routine treatment and nursing for chronic heart failure.The observation group was applied with hospital-community-home integrated cardiac rehabilitation model for intervention management on the basis of routine treatment and nursing of chronic heart failure.Cardiopulmonary reserve,6-minute walk distance(6MWT),levels of serum N-terminal pro-B-type natriuretic peptide(NT-proBNP),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and nitric oxide(NO)before and after rehabilitation were collected,and were compared between the two groups.Results After 1 year of rehabilitation intervention,the levels of peakVO2,VO2AT,and 6MWD in the two groups were higher than those before rehabilitation intervention,and the observation group was higher than the control group(P<0.05).LAVI,NT-proBNP,TNF-α,and IL-1βin the two groups were lower than those before intervention(P<0.05),and those in the observation group was lower than the control group(P<0.05).Conclusion Compared with routine treatment and nursing,the model is more beneficial to the recovery of cardiopulmonary reserve and the reduction of inflammatory level in patients with HFPEF.The patients have a better prognosis.It is worthy of clinical promotion.
作者
邱清艳
杜薇
牟英
戴闽
罗彩东
李郁
QIU Qing-yan;DU Wei;MOU Ying;DAI Min;LUO Cai-dong;LI Yu(Department of Cardiology,Mianyang Central Hospital,Mianyang 621000,China)
出处
《实用医院临床杂志》
2022年第1期81-85,共5页
Practical Journal of Clinical Medicine
基金
2018年度四川省基层卫生事业发展研究中心资助项目(编号:SWFZ18-Q-4)。
关键词
心脏康复管理
射血分数保留心力衰竭
心肺功能
脑利钠肽前体
6分钟步行距离
炎症因子
Cardiac rehabilitation
Heart failure with preserved ejection fraction
Cardiopulmonary function
N-terminal pro-brain natriuretic peptide
6-minute walking distance
Inflammatory cytokines
