| 刘海燕,李 良,王莎莎,王 翠,于 嫚.心肺运动测试指导心脏康复联合正念认知疗法对老年慢性心力衰竭患者心肺功能、焦虑抑郁情绪和预后的影响[J].,2022,(10):1851-1855 |
| 心肺运动测试指导心脏康复联合正念认知疗法对老年慢性心力衰竭患者心肺功能、焦虑抑郁情绪和预后的影响 |
| Effects of Cardiopulmonary Exercise Test Guided Cardiac Rehabilitation Combined with Mindfulness-Based Cognitive Therapy on Cardiopulmonary Function, Anxiety, Depression and Prognosis in Elderly Patients with Chronic Heart Failure |
| 投稿时间：2021-12-08 修订日期：2021-12-30 |
| DOI：10.13241/j.cnki.pmb.2022.10.011 |
| 中文关键词: 心肺运动测试 心脏康复 正念认知疗法 老年 慢性心力衰竭 |
| 英文关键词: Cardiopulmonary exercise test Cardiac rehabilitation Mindfulness-based cognitive therapy Elderly Chronic heart failure |
| 基金项目:北京市自然科学基金项目（7161169） |
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| 中文摘要: |
| 摘要 目的：观察心肺运动测试（CPET）指导心脏康复联合正念认知疗法（MBCT）对老年慢性心力衰竭（CHF）患者心肺功能、焦虑抑郁情绪和预后的影响。方法：选取2018年8月~2020年5月期间中国人民解放军总医院第四医学中心老年医学科收治的156例老年CHF患者，根据双色球随机分组法将患者分为对照组（78例，常规治疗基础上接受CPET指导心脏康复干预）和观察组（78例，对照组基础上结合MBCT干预）。观察两组患者的心肺功能、焦虑抑郁情绪变化和预后情况。结果：两组患者的二氧化碳通气当量斜率（VE/VCO2slop）、左室舒张末径（LVEDD）干预后均下降，峰值氧耗量（peak VO2）、无氧阈氧耗量（VO2AT）、左室射血分数（LVEF）干预后均升高（P<0.05）。观察组干预后VE/VCO2slop、LVEDD低于对照组，peakVO2、VO2AT、LVEF高于对照组（P<0.05）。两组患者的汉密尔顿抑郁量表17项(HAMD-17)、汉密尔顿焦虑量表（HAMA）评分干预后均下降（P<0.05）。观察组干预后HAMD-17、HAMA评分低于对照组（P<0.05）。观察组患者的1年内再住院率、1年内死亡率均低于对照组患者（P<0.05）。结论：CPET指导心脏康复联合MBCT干预老年CHF患者，可促进其心肺功能恢复，改善其焦虑抑郁情绪，降低1年内再住院率、1年内死亡率。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of cardiopulmonary exercise test (CPET) guided cardiac rehabilitation combined with mindfulness-based cognitive therapy (MBCT) on cardiopulmonary function, anxiety, depression and prognosis in elderly patients with chronic heart failure (CHF). Methods: 156 elderly patients with CHF who were treated in the Geriatric Department of the Fourth Medical Center of PLA General Hospital from August 2018 to May 2020 were selected. According to the two-color ball method, the patients were divided into control group (78 cases, receiving CPET guided cardiac rehabilitation intervention on the basis of routine treatment) and observation group (78 cases, combined with MBCT intervention on the basis of control group). The changes of cardiopulmonary function, anxiety and depression and prognosis of patients in both groups were observed. Results: The carbon dioxide ventilation equivalent slope (VE/VCO2slop), left ventricular end diastolic diameter (LVEDD) in two groups after intervention decreased. Peak oxygen consumption (peak VO2), anaerobic threshold oxygen consumption (VO2AT), left ventricular ejection fraction (LVEF) after intervention increased (P<0.05). VE/VCO2slop, LVEDD in the observation group after intervention were lower than those in the control group, and peakVO2, VO2AT, LVEF were higher than those in the control group (P<0.05). The scores of 17 items of Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA) in the two groups after intervention decreased (P<0.05). The scores of HAMD-17 and HAMA in the observation group after intervention were lower than those in the control group (P<0.05). The rehospitalization rate within one year and mortality within one year in the observation group were lower than those in the control group (P<0.05). Conclusion: CPET guided cardiac rehabilitation combined with MBCT in the treatment of elderly patients with CHF can promote the recovery of cardiopulmonary function, improve anxiety and depression, and reduce the rehospitalization rate within one year and mortality within one year. |
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