摘要
目的:有研究表明在动脉粥样硬化的发展和易损斑块的破裂中,炎症和高脂血症是其重要特征。为此探讨康复运动是否可以通过干预病理发生发展过程中血脂和炎症反应来预防、延缓动脉粥样硬化。方法:①实验对象:选取湖北省华中科技大学附属同济医院2006-07/2007-04筛查确诊的动脉粥样硬化患者64例,在知情同意的原则下,随机数字表法分为康复运动组34例,空白对照组30例,两组性别、年龄及病史等比较差异均无显著性意义(P>0.05)。②实验方法:两组患者保持平时的饮食习惯及一般的体力活动,分别于实验前后禁食12h后的清晨采集空腹肘静脉血2mL,定量检测C-反应蛋白浓度、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油。此外康复运动组患者接受运动干预,进行功率自行车、跑步机等项目锻炼,使大肌群进行规律性的有氧代谢运动;运动时机为进餐0.5～1.0h后,每次持续0.5～1.0h;运动强度为60%～90%最大心率,或50%～85%的心率储备;运动量根据运动强度和持续时间灵活掌握,循序渐进;运动频度为每周进行6d,坚持6周。③测定实验前和康复运动6周后两组血清中C-反应蛋白浓度及血脂生化指标的变化。结果:空白对照组1例在出院后失去联系而脱落,康复运动组2例因感冒发烧而退出实验,其余患者均进入结果分析。①两组实验前后血脂水平的变化:与实验前比较,干预后康复运动组低密度脂蛋白胆固醇、三酰甘油均显著降低(P<0.05),高密度脂蛋白胆固醇显著升高(P<0.05);空白对照组无明显变化(P>0.05)。②两组实验前后血浆C-反应蛋白浓度的变化:与实验前比较,干预后康复运动组血浆C-反应蛋白浓度显著降低(P<0.05),空白对照组无明显变化(P>0.05)。③康复运动后血浆C-反应蛋白浓度的变化与血脂变化的相关性分析:康复运动组血浆C-反应蛋白浓度降低率与血浆低密度脂蛋白胆固醇浓度降低不相关(r=0.014,P>0.05),与血浆高密度脂蛋白胆固醇浓度升高呈负相关(r=-0.23,P<0.05)。结论:康复运动能够有效地改善动脉粥样硬化患者血清中C-反应蛋白浓度及血脂生化指标,可成为预防冠状动脉粥样硬化性心脏病的有效措施。
AIM： It is reported that inflammation and hyperlipemia are commonly found in the development of atherosclerosis and disruption of easily damaged plaque. The article is designed to study whether rehabilitation exercise can prevent and delay atherosclerosis by improving blood fat and inflammatory reaction during pathological development. METHODS： （1）Totally 64 patients with atheroschlerosis were enrolled from Tongji Hospital Affiliated to Huazhong University of Science and Technology from July 2006 to April 2007. With their agreement, the patients were randomly assigned to rehabilitation exercise group （n =34） and blank control group （n =30）. No significant difference was found in sex, age and case history （P 〉 0.05）. （2）They kept their habit in diet and general activities. 2 mL ulnar vein blood was collected from fasting patients before and after the operation, respectively to detect levels of C reactive protein, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C） and triglyceride （TG）. The patients of rehabilitation exercise group mainly referred to ride cycle ergometer or treadmill, so muscle group could receive regularly aerobic metabolism. The exercise was performed 0.5-1.0 hour after dinner for 0.5-1.0 hour once, with the maximal heart rate of 60%-90% or heart rate reservation of 50%-85%. The exercise intensity was monitored by rating of perceived exertion,6 days per week for 6 weeks. （3）The serum C-reactive protein and blood fat levels were determined before the operation and 6 weeks after rehabilitation exercise. RESULTS：One patient of the blank control group was dropped out, because of being out of touch, and two patients of the rehabilitation exercise group drooped out, because of catarrhal rhinitis and fervescence. Others were involved in the result analysis. （1）LDL-C and TG levels were significantly lower, HDL-C level was higher in the rehabilitation exercise group after intervention as compared with that before experiment （P 〈 0.05）. No significant difference was found in the blank control group （P 〉 0.05）. （2）C reactive protein in plasma was lower in the rehabilitation exercise group after intervention as compared with that before experiment （P 〈 0.05）, while no significant difference was seen in the blank control group （P 〉 0.05）. （3）The decrease of plasma C reactive protein level was not associated with the decrease of plasma LDL-C level （r =0.014,P 〉 0.05）, but negatively correlated with the increase of plasma HDL-C level （r =-0.23, P 〈 0.05）. CONCLUSION： The rehabilitation exercise could improve the C reactive protein and blood fat of atherosclerotic and serve as an effective measure to prevent and cure coronary atherosclerotic heart disease.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第43期8703-8706,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
