摘要
目的观察慢性心力衰竭(CHF)患者胰岛素抵抗(IR)状态及运动训练对IR的影响。方法将120例心功能Ⅱ～Ⅲ级的CHF患者(观察组)随机分为训练组(n=65)和常规治疗组(n=55),2组患者均接受常规的抗心衰药物治疗,训练组还接受每天2次6 min步行运动训练,连续20周。比较2组患者治疗前、后胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)、6 min步行距离、心率(HR)及平均血压(MBP),并将观察组治疗前的HOMA-IR、ISI与对照组(n= 32)比较。结果与对照组相比,观察组ISI降低,HOMA-IR增加(P<0.01)。治疗后,观察组LVEF值、LVFS、6 min步行距离及ISI升高,而HR、MBP及HOMA-IR降低。相对于常规治疗组,训练组治疗后LVEF、LVFS、6 min步行距离、ISI增高和HOMA-IR、HR、MBP降低的程度更明显(P<0.05)。结论CHF患者存在IR,运动训练在改善其心功能及运动功能的同时,也能改善其IR。
Objective To investigate insulin resistance and the effect of physical training on it in the patients with chronic heart failure （CHF）. Methods One hundred and twenty NYHA Ⅱ-Ⅲ CHF patients were ran- domly divided into a training group（n = 65 ） and a routine therapy group （n = 55 ）. Another 35 healthy subjects were recruited as control group. All the patients were treated with routine anti-CHF drugs, and the training group patients had received physical training twice a day in addition. The HOMA-IR, insulin sensitivity index （ISI） , left ventricular ejection fraction （LEVF） , left ventricular fractional shortening（LVFS） , 6-minute walking distance, heart rate and mean blood pressure were compared between the training and routine therapy groups before and after physical exercise in both groups, and a comparison was made between the patients and the controls before the intervention with regard to HOMA-IR and ISI. Results Comparing with control group, ISI was reduced while the HOMA-IR increased （P 〈0. 001 ） in the patients with CHF. After physical training, the patients were improved to a significantly larger extent than those treated with routine therapy, in terms of LVEF, LVFS, 6-minute walking distance and ISI, as well as heart rate, mean blood pressure and HOMA-IR （ P 〈0. 05 ）. Conclusion IR exists in the patients with CHF. Physical training could improve both IR and heart function as well as the movement function of the patients with CHF.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2007年第10期667-669,共3页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
心力衰竭
胰岛素抵抗
运动训练
Heart failure
Insulin resistance
Physical training
