有氧康复运动疗法对冠脉成形术后患者血清超氧化物歧化酶活性及泛素水平影响的临床研究

关键词：冠心病  运动疗法  内皮功能  超氧化物歧化酶  泛素

Keywords:coronary artery disease  exercise therapy  endothelium function  superoxide dismutases  ubiquitin

摘要：

      摘要 目的：探讨有氧康复疗法对冠心病冠脉成形术(PCI）后患者血清超氧化物歧化酶活性、泛素水平及炎性因子(NF-κb)的影响。 方法：选择96例冠心病接受PCI患者。分为有氧康复运动组(治疗组)48例和单纯PCI对照组48例。6、12个月后均采用了Bruce方案亚极量分级运动试验进行康复评定，并测定血清超氧化物歧化酶SOD活性、NF-κb及泛素水平的表达，彩色多普勒超声探测肱动脉内皮功能。12个月后行冠脉造影术判定相关血管的动脉粥样硬化进展情况。 结果：随访12个月后，①与对照组比较，治疗组患者的血清SOD活性显著升高(178±19μl vs 163±21μl，P<0.01)、单核细胞NF-κb mRNA表达(0.79±0.7 vs 1.38±0.8)及泛素水平(3.7±1.8ng/ml vs 6.3±1.9，P<0.01) 显著降低；②运动试验评定：治疗组运动时间(16.3±1.5min vs 13.6±1.7min, P<0.01)、运动耐量(17.1±1.5METs vs 14.7±1.8METs, P<0.01)均显著高于对照组，自感用力度分级(9.3±0.6 vs 12.2±1.9，P<0.01)显著低于对照组；③治疗组内皮依赖性舒张功能指标血流介导的血管舒张功能（FMD）较对照组明显改善(8.3%±1.9% vs 6.0%±1.7%, P<0.01)。 结论：冠心病PCI后患者经有氧康复运动治疗可提高血清SOD活性，使泛素水平明显下调，降低NF-κb的表达，并能改善血管内皮功能，有助于减缓动脉粥样硬化的进展。

Abstract:

      Abstract Objective：To investigate the rehabilitation aerobatic exercise on the activity of serum superoxide dismutases and ubiquitin in the patients with coronary artery disease who underwent PCI. Method: A total of 96 patients were divided into two groups: the treatment group and the control group, the therapeutic group undertook regular rehabilitation aerobatic exercise, the control group only accept standardized medicine therapy and ordinary activity. Bruce submaximal treadmill, Doppler examination for the rehabilitation assessment of brachial artery for lateral branch circulative endothelium function, serum superoxide dismutases（SOD）， serum ubiquitin and NF-κb mRNA expression on the monocyte were evaluated in six month and twelve month later, the coronary angiography was conducted only in twelve month later. Result: ①The serum superoxide dismutases on the treatment group were significantly higher than that of the control group(178±19μl vs163±21μl,P<0.01), the serum ubiquitin and NF-κb mRNA expression on the monocyte on the treatment group were significantly lower than that of the control group(0.79±0.7 vs1.38±0.8). ② The exercise time, the exercise tolerance (16.3±1.5min vs 13.6±1.7min,P<0.01)and RPE(17.1±1.5 METs vs 14.7±1.8 METs,P<0.01) on the treatment group were higher than that of the control group. ③ The FMD were significantly increased after rehabilitation aerobatic exercise in the therapeutic group(8.3%±1.9% vs 6.0%±1.7,P<0.01). Conclusion: The regular rehabilitation with aerobatic exercise can improved the activity of serum superoxide dismutases, reduced the serum ubiquitin and NF-κb mRNA expression on the monocyte, ameliorated the vascular endothelium function, and accordingly retard the progression of the atherosclerosis.