长期游泳和跑步运动对中年男性血管内皮功能和血流动力学的影响

关键词：游泳  跑步  中年男性  血流动力学  内皮功能

Keywords:swimming  running  middle-aged men  hemodynamics  endothelial function

摘要：

      摘要 目的：探讨长期游泳、跑步锻炼对正常血脂血压、高血脂、高血压中年男性血管内皮功能和血流动力学的影响。 方法：于北京某社区招募45—65岁中年男性，通过对血压、血脂、运动锻炼习惯等问卷调查，最终将其分为：正常静坐组、正常跑步组、正常游泳组，高血脂静坐组、高血脂跑步组、高血脂游泳组，高血压静坐组、高血压跑步组、高血压游泳组。采用日本UNEX EF血管内皮功能检测仪测试肱动脉血流介导的内皮舒张功能（flow-mediated dilation，FMD），美国GE vivid7彩超仪测试颈动脉阻力系数（RI）、收缩期峰值流速（PSV）、颈动脉内径（VD），并计算颈动脉血管壁面剪切力（wall shear stress，WSS）。 结果：高血脂、高血压静坐组FMD均显著低于正常静坐组（P＜0.05），各游泳组FMD均显著高于相对应的静坐组（P＜0.05）。高血脂静坐WSS、PSV均显著低于正常静坐组（P＜0.05），游泳组WSS均高于相对应的静坐组，跑步组、游泳组PSV值均高于各自对应的静坐组。高血脂、高血压静坐组RI均显著高于正常静坐组（P＜0.05），高血压静坐组VD显著高于正常静坐组（P＜0.05）。相关分析显示，FMD与WSS、PSV呈现正相关（P＜0.05），与RI、年龄呈负相关（P＜0.05）。WSS与年龄、BMI、舒张压为负相关（P＜0.05），与高密度脂蛋白呈现正相关（P＜0.05）。 结论：长期游泳锻炼可以改善不同血脂、血压水平的中年人血管内皮功能，可能与血流剪切力提高有关，在该强度下跑步运动的作用不明显，建议对于不能承受大强度跑步又希望提升血管内皮功能的中年男性选择游泳运动。

Abstract:

      Abstract Objective： To investigate the effects of long-term swimming and running on vascular endothelial function and hemodynamics in middle-aged men with normal blood lipid and blood pressure， simple hyperlipidemia and simple hypertension. Method： The men aged 45—65 were recruited in a Beijing community and finally divided into： normal no-exercise group， normal running group， normal swimming group， hyperlipidemia no-exercise group， hyperlipidemia running group， hyperlipidemia swimming group， hypertension no-exercise group， hypertension running group， hypertension swimming group by the investigation survey on blood pressure， blood lipids and exercise habits. Brachial artery flow-mediated endothelial relaxation function （FMD） was tested by Japanese UNEX EF vascular endothelial function detector， and carotid artery resistance coefficient （RI）， peak systolic velocity （PSV）， and carotid artery diameter （VD） were measured by GE vivid7 ultrasound and carotid artery wall shear force （WSS） was calculated. Result： FMD in the hyperlipidemia and hypertension sedentary group was significantly lower than that in the normal sedentary group （P<0.05）， and FMD in swimming groups was significantly higher than that in the corresponding sedentary group （P<0.05）. The WSS and PSV of the hyperlipidemia sedentary group were significantly lower than those of the normal sedentary group （P<0.05）， the WSS of the swimming group was higher than that of the corresponding sedentary group， and the PSV of the running and swimming groups was higher than that of the corresponding sedentary group. RI in the hyperlipidemia and hypertensive sedentary group was significantly higher than that in the normal sedentary group （P<0.05）， and VD in the hypertensive sedentary group was significantly higher than that in the normal sedentary group （P<0.05）. Correlation analysis showed that FMD was positively correlated with WSS and PSV （P<0.05）， and negatively correlated with RI and age （P<0.05）. WSS was negatively correlated with age， BMI and diastolic blood pressure （P<0.05）， and positively correlated with high-density lipoprotein （P<0.05）. Conclusion： Long-term swimming exercise can improve vascular endothelial function in middle-aged men with different levels of blood lipid and blood pressure， which may be related to the improvement of the carotid artery wall shear force. Running at this intensity has no obvious effect on the vascular endothelial function. Therefore, the middle-aged men who cannot withstand high-intensity running but want to improve vascular endothelial function should choose swimming exercise.