不同类型运动训练对抑制心肌梗死患者内皮依赖性舒张的试验研究

关键词：内皮依赖性  运动干预  心肌梗死  内皮依赖性血流介导的血管舒张

Keywords:endothelial dependence  exercise intervention  myocardial infarction  flow mediated dilation

摘要：

      摘要 目的：通过测量内皮素水平、血流介导的舒张功能，血管性血友病因子（vWF因子）水平变化评估不同类型运动训练对内皮功能的影响。 方法：招募48例受试患者（年龄≥60岁）随机分为4组，A1—A3组分别接受有氧训练、抗阻训练、联合训练，A4组不训练，观察前后24周肱动脉血管的反应性和中断训练后血管内皮功能变化规律。 结果：在基准水平血流介导的扩张情况，A1组：4.6±2.5%，A2组：4.3±1.7%，A3组：4.3±3.8%，A4组：4.1±2.5%。经过24周运动训练之后，A1组：9.8±2.4%，A2组：10.0±2.8%，A3组：10.6±3%；较基线值水平血流介导扩张呈现非常显著提高（P<0.01）。A4组(4.4±2.8%)随访值比例也有所上升（P<0.05），与试验组比较程度要小得多。在A1—A3组中的vWF因子水平在中断训练后下降了16%（P<0.01），逐渐恢复基准水平，A4组保持不变。 结论：心肌梗死患者中，内皮功能的改善与训练类型无关，中断训练1个月后内皮功能变化会逐渐消失。

Abstract:

      Abstract Objective： The effects of different types of exercise training on endothelial function were evaluated by measuring endothelin level， blood flow-mediated diastolic function and von Willebrand factor（vWF） factor level. Method： Forty-eight patients (aged over 60 years) were randomly divided into four groups. Group A1-A4 received aerobic training， resistance training， combined training or no training, respectively. After 24 weeks of withdrawal training，the reactivity of brachial artery vessels and the changes of vascular endothelial function were observed. Result： At baseline level， the blood flow-mediated dilations were： A1(4.6±2.5%)， A2 (4.3±1.7%)， A3(4.3±3.8%)，A4(4.1±2.5%). After 24 weeks of exercise training， the dilations were A1 (9.8±2.4%)， A2(10.0±2.8%)，A3(10.8±3%)， increasing significantly when compared with those of baseline level (P<0.01). The proportion of follow-up values in group A4 (4.4±2.8%) also increased， but to a much smaller extent. The level of vWF factor in A1-A3 group decreased by 16% (P<0.01) after withdrawal training， and gradually returned to the baseline level， while that in A4 group remained unchanged. Conclusion： The improvement of endothelial function in patients with myocardial infarction is not related to the type of training. The change of endothelial function will gradually disappear after one-month withdrawal training.