摘要
目的 :探讨 6min步行试验 (6MWT)对老年慢性心力衰竭 (CHF)患者运动耐量的评价。方法 :将 5 4例CHF患者随机分为常规治疗组 (n =2 5 )和卡维地洛组 (n =2 9) ,治疗前后进行步行试验 ,监测肿瘤坏死因子(TNF α)、白细胞介素 6 (IL 6 )、去甲肾上腺素 (NE)和左室射血分数 (LVEF)。结果 :心功能Ⅳ级患者较Ⅱ级患者步行距离明显下降 (P <0 .0 1) ,Ⅲ级与Ⅱ级、Ⅳ级与Ⅲ级患者之间步行距离的差异无显著性意义 (P >0 .0 5 ) ;卡维地洛组 6min步行距离治疗前后差异有显著性意义 (P <0 .0 1) ,而常规治疗组差异无显著性意义 (P >0 .0 5 ) ,两组患者步行距离与TNF α、IL 6、NE呈显著负相关 (P <0 .0 5 ) ,与LVEF呈正相关 (P <0 .0 5 )。结论 :6MWT具有简单、易行、安全、可靠的特点 ,可作为评估CHF患者运动耐量的临床工具 ,尤其适用于老年患者 。
Objective:To assess 6-minute walking test(6MWT) on exercise tolerance in elderly patients with chronic heart failure. Methods:Fifty four patients with chronic heart failure were divided into two groups at random. In the routine group (n=25), patients were treated by ACE inhibitors, diuretics and digoxin, and in the carvedilol group (n=29) treated by ACE inhibitors,diuretics, digoxin and carvedilol. All patients underwent 6MWT before and after the treatment.At the same time, The plasma concentration of TNF α, IL 6 and NE were measured. LVEF was also detected. Results:Compared with the patients in New York Heart Association(NYHA) class Ⅱ, 6MWTdistance in the patients in NYHA class Ⅳ was significantly decreased [( 345.00 ± 48.56 )m vs ( 369.00 ± 52.15 )m, P< 0.01 ]. But there was no difference either between NYHA class Ⅲ and NYHA classⅡ or between NYHA class Ⅲ and NYHA class Ⅳ. There was significant difference on 6MWT distance covered before and after the treatment in the carvedilol group (P< 0.01 ), but there was no difference in the routine group (P> 0.05 ). Meanwhile, 6MWT distance covered was negatively correlated with TNF α, IL 6 and NE (r= -0.62 , -0.59 , -0.60 , respectively P< 0.05 ), but positively correlated with LVEF (r= 0.63 , P< 0.05 ). Conclusion:6 MWT is a simple, inexpensive, safe and reproducible means of assessing exercise tolerance in chronic heart failure especially for the elderly patients. It can also provide a clinical test to judge the curative effect and prognosis.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2003年第10期601-603,共3页
Journal of Clinical Cardiology
关键词
心力衰竭
充血性
6分钟步行试验
运动耐量
Heart failure, congestive
6 minute walking test
Exercise tolerance
