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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 ,同时可提供一定的判断CHF预后及治疗效果的信息
Objective: To evaluate the 6-minute walking test (6MWT) in elderly patients with chronic heart failure (CHF) evaluation of exercise tolerance. Methods: Fifty-four CHF patients were randomly divided into routine treatment group (n = 25) and carvedilol group (n = 29). Pedestrian tests were performed before and after treatment to monitor the levels of tumor necrosis factor (TNF), interleukin 6 (IL6), norepinephrine (NE), and left ventricular ejection fraction (LVEF). Results: The walking distance of grade IV patients with cardiac function was significantly lower than that of grade Ⅱ patients (P <0.01). There was no significant difference in walking distance between patients with grade Ⅲ and Ⅱ, grade Ⅳ and grade Ⅲ (P> 0 .0 5). The carvedilol group had a significant difference in 6-minute walking distance before and after treatment (P <0.01), but there was no significant difference between the conventional treatment groups (P> 0.05) The walking distance was negatively correlated with TNFα, IL 6 and NE (P <0.05), and positively correlated with LVEF (P <0.05). Conclusion: 6MWT is a simple, easy, safe and reliable tool that can be used as a clinical tool to evaluate exercise tolerance in patients with CHF, especially for elderly patients. At the same time, 6MWT can provide some information to judge prognosis and therapeutic effect of CHF