张振宇,杨志军,杨进华,等.有氧运动对肺动脉高压患者右心室重塑、心肺适能及睡眠质量的影响[J].中华物理医学与康复杂志,2025,47(5):413-418
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| 有氧运动对肺动脉高压患者右心室重塑、心肺适能及睡眠质量的影响 |
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| DOI：10.3760/cma.j.cn421666-20241108-00860 |
| 中文关键词: 有氧运动 肺动脉高压 睡眠质量 心肺适能 峰值摄氧量 |
| 英文关键词: Aerobic exercise Pulmonary hypertension Sleep quality Cardiopulmonary fitness Peak oxygen uptake |
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| 中文摘要: |
| 目的 观察有氧运动对肺动脉高压（PAH）患者右心室重塑、心肺适能及睡眠质量的影响。 方法 采用随机数字表法将60例无规律运动习惯的稳定期PAH患者分为观察组及对照组，对照组患者给予规范靶向药物治疗，观察组患者在对照组干预基础上辅以3次/周、共12周的有氧运动训练。于干预前、后分别采用超声心动图检测患者右心室舒张末期容积（RVEDV）、右心室收缩末期容积（RVESV）、右心室每搏输出量（RVSV）及右心室射血分数（RVEF）；通过心肺运动测试获取患者峰值摄氧量（VO2peak）、峰值心率（HRpeak）、峰值做功（Wpeak）及运动时间（ET）等重要参数；采用匹兹堡睡眠质量指数（PSQI）量表评估患者睡眠质量。 结果 与干预前比较，干预后观察组超声心动图指标RVEDV、RVESV［分别为(75.2±9.6)ml、(44.3±7.7)ml）］均明显减少（P<0.05），RVSV、RVEF［（分别为(39.7±4.7)ml、(51.2±6.5)%）］则显著增加（P<0.05），心肺运动测试中VO2peak、Wpeak及ET［分别为（22.7±3.0）ml/kg/min、（78.3±8.0）W、（9.7±1.3）min］均显著增加（P<0.05），HRpeak无显著性改变（P>0.05），PSQI量表各项指标评分均明显降低（P<0.05）；对照组干预后上述各项指标数据均无显著改变（P>0.05）。通过进一步组间比较发现，干预后观察组VO2peak、Wpeak、ET、RVSV、RVEF均较对照组显著增加（P<0.05），PSQI量表各项指标评分以及RVEDV、RVESV均较对照组明显减少（P<0.05）。 结论 规律有氧运动能显著改善PAH患者右心室重塑、心肺适能及睡眠质量，有助于降低患者死亡率，该疗法值得临床推广、应用。 |
| 英文摘要: |
| Objective To observe the effect of aerobic exercise on cardiopulmonary fitness, sleep quality, and right ventricular remodeling in patients with pulmonary arterial hypertension (PAH). Methods Sixty stable PAH patients without regular exercise habits were randomly divided into an observation group and a control group according to a random number table. Both groups received standard targeted drug therapy, but the observation group additionally performed aerobic exercise three times per week for 12 weeks. Before and after the intervention, the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, while echocardiography was performed to measure the end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV), and ejection fraction (RVEF) of the participants′ right ventricles. In addition, cardiopulmonary exercise testing was conducted to obtain peak oxygen uptake (VO2peak), peak heart rate (HRpeak), peak work (Wpeak), and exercise time (ET). Results In the observation group, the average scores of all items in the PSQI scale, as well as the echocardiography indicators of RVEDV and RVESV decreased significantly compared with before the intervention. VO2peak, Wpeak and ET in the cardiopulmonary exercise test, as well as RVSV and RVEF had increased significantly. There was no significant change in HRpeak, on average. There was also no significant change in any of these indicators in the control group, on average. The left the observation group′s average VO2peak, Wpeak, ET, RVSV and RVEF significantly higher than in the control group, while their PSQI scale scores, RVEDV and RVESV were significantly lower. Conclusions Regular aerobic exercise can improve sleep quality and promote cardiopulmonary fitness and right ventricular remodeling in PAH patients. That should tend to help reduce mortality, so such therapy is worthy of clinical promotion and application. |
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