新疆医科大学学报

目的 探究主动呼吸循环训练(Active breathing cycle training, ABCT)联合坎地沙坦酯对老年肺心病(Pulmonary heart disease, PHD)并呼吸衰竭患者微循环、肺功能影响。方法 选取2021年1月-2022年6月新疆医科大学第一附属医院干部保健中心综合内三科收治的130例老年肺心病并呼吸衰竭患者为研究对象，随机分为对照组和联合组，2组患者均口服坎地沙坦酯(每天1次，每次1片，口服14 d),对照组采用常规保健型运动训练(训练1个月),联合组采用ABCT(训练1个月)。采用微循环显微镜评估甲襞微循环指标，肺功能检测仪评估肺功能指标，彩色多普勒超声及6 min步行试验评估心功能指标。结果 与对照组比较，联合组总有效率增大，差异有统计学意义(P<0.05)。与对照组干预后比较，联合组干预后管襻形态积分、血流状态积分、襻周状态积分及总积分降低，毛细血管流速，最大肺活量(VCmax)、用力肺活力(FVC)、第1s用力呼气容积(FEV₁)、峰值呼气流速(PEF)水平和左室射血分数(LVEF)水平均升高，6 min步行距离(6MWD)增加，差异有统计学意义(P<0.05)。结论 ABCT联合坎地沙坦酯能够明显提升老年PHD并呼吸衰竭患者临床疗效，改善血液微循环，提升毛细血管流速和患者心肺功能。

Objective To explore the effects of active breathing cycle training(ABCT) combined with Candesartan ester on microcirculation and lung function in elderly patients with pulmonary heart disease(PHD) and respiratory failure. Methods 130 elderly patients with pulmonary heart disease and respiratory failure admitted to the hospitalfrom January 2021 to June 2022 were selected as the study subjects, and the patientswere randomly divided into control group and combination group. All patients in both groups were given Candesartan ester(once a day, 1 tablet each time, for 14 days). The control group received routine health exercise training(training for 1 month), and the combined group received ABCT(training for 1 month). Nail fold microcirculation was evaluated by microcirculation microscope, pulmonary function was evaluated by pulmonary function detector, and cardiac function was evaluated by color Doppler ultrasound and 6 min walking test. Results Compared with the control group, the total effective rate of the combined group wasincreased, and the difference was statistically significant(P<0.05). After intervention, compared with the control group, in the combined group, the loop shape integral, blood flow state integral, loop surrounding state integral and total integral wasdecreased, and the capillary flow rate, maximum vital capacity(VCmax), forced pulmonary viability(FVC), forced expiratory volume in the first second(FEV₁), peak expiratory flow rate(PEF) and left ventricular ejection fraction(LVEF) levels wereincreased, and the 6-minute walking distance(6MWD) was increased, with statistically significant differences(P<0.05). Conclusion ABCT combined with Candesartan ester can significantly improve clinical efficacy, improve blood microcirculation, capillary velocity and cardiopulmonary function in elderly patients with PHD and respiratory failure.