摘要
目的:多因素Logistic回归模型回顾性分析规律运动锻炼等影响因素与研究终点的关系,观察规律运动锻炼对慢性心力衰竭患者预后的影响。方法:选择2002-01/2004-03因冠心病、扩张性心肌病、高血压病引起慢性心力衰竭首次在北京大学第三医院心内科住院的患者73例。采用电话与通信方式随访其出院1年内的身体状况、用药情况、再住院以及日常锻炼情况等,其中规律运动锻炼指每日活动至少30min,每周至少5d,运动方式包括步行、慢跑、骑单车等。以1年内死亡或因心力衰竭再住院为研究终点,运用多因素Logistic回归模型回顾性分析规律运动锻炼等影响因素与研究终点的关系。结果:73例慢性心力衰竭患者中坚持规律运动锻炼者32例(43.8%),运动锻炼不规律或不锻炼者41例(56.2%)。①1年内因心力衰竭死亡17例,其中运动锻炼不规律或不锻炼者15例(36.6%),规律运动锻炼者2例(6.3%),差异有显著性意义(P<0.01);1年内因心力衰竭再住院40例(54.8%),其中运动锻炼不规律或不锻炼者28例(68.3%),规律运动锻炼者12例(37.5%),规律运动锻炼对再住院也是一个负性影响因素(P<0.01)。②多因素分析显示,排除性别、年龄、心功能分级、射血分数、有无合并症及治疗情况等干扰因素后,规律运动锻炼是预测慢性心力衰竭患者1年内死亡和再住院的独立因素。结论:以规律运动锻炼为主的康复治疗减少了慢性心力衰竭患者1年内的病死率和因心力衰竭再住院率。
AIM： To analyze the relationship between end-point index and the interventions during regular exercises by multiple factor Logistic regression and study the effect of the regular exercises training on the prognosis of the patients with chronic heart failure. METHODS： Totally 73 patients with chronic heart failure induced by coronary heart disease, dilated cardiomyopathy and hypertensive disease hospitalized for the first time at the Third Hospital of Peking University from January 2002 to March 2004. Physical status, medicine and rehospitalization and daily exercises were followed up by telephone and communication within 1 year. Regular exercises were at least 30 minutes every day and at least 5 days every week. Mode of exercise contained walking, jogging and by bike. The end of evaluation was the death or rehospitalization due to heart failure within one year after initial discharge. The Logistic regression was used to analyze the relationship between the end-point index and the interventions. RESULTS： Among the 73 patients, 32 patients had a regular exercises （43.8%）, at the same time, 41 patients had not （56.2%）. （1）Seventeen patients had died due to heart failure within 1 year, of which 15 patients of died had not regular exercises or no exercises （36.6%） during follow-up, and 2 patients had regular exercises （6.3%） （P 〈 0.01 ）. Forty patients were rehospitalized （54.8%） among total patients after 1 year follow-up, of which 28 patients who rehospitalized had not undergone regular exercises training （68.3%） since had discharged, and 12 patients had regular exercises （37.5%）. The regular exercises intervention was negatively correlated with the rehospitalization in the patients with chronic heart failure （P 〈 0.01 ）. （2）Multiplicity showed that regular exercises were the independent factor of death and rehospitalization within 1 year of chronic heart failure patients with the exception of sex, age, cardiac functional grading, ejection fraction, complication and treatment. CONCLUSION： The rates of death and rehospitalization have been significantly decreased by rehabilitation, mainly regular exercise, in chronic heart failure patients who initial discharge from hospital within one year.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第52期10506-10508,10512,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
作者简介
杜丽娟，女，1972年生．河北省邢台市人，汉族，2004年北京大学医学部毕业，硕士，副主任医师，主要从事心血管内科临床与科研工作。Juandd@sohu．com
通讯作者：张福春，北京大学第三医院心内科，北京市100083
