康复运动对心衰患者血浆可溶性粘附分子水平的影响

Effects of rehabilitation exercise on plasma levels of soluble cell adhesion molecules in patients with congestive heart failure

目的:通过观察充血性心力衰竭(CHF)患者运动训练前、后血浆可溶性细胞间粘附分子-1(sICAM-1)、血管细胞粘附分子-1(sVCAM-1)和E-选择素(sE-selectin)水平的变化,探讨其临床意义。方法:用ELISA法检测23例CHF患者6 min步行运动试验前、后血浆sICAM-1、sVCAM-1、sE-selectin水平,并以20例健康体检者作为对照,18例患者运动训练一个月后进行了随访。结果:CHF患者基础状态血浆sICAM-1、sVCAM-1和sE-selectin水平显著高于对照组(P<0.05-<0.01),且sICAM-1、sVCAM-1水平与心功能密切相关(P<0.05);运动后即刻sICAM-1、sVCAM-1水平较运动前升高(P<0.05),而sE-selectin水平运动前、后无显著性差异;康复训练一月后,无论基础状态还是运动后,sICAM-1、sVCAM-1水平较前次实验明显降低(P<0.05),而sE-selectin水平无显著性变化。结论:CHF患者血浆可溶性粘附分子水平较正常升高,6 min步行运动试验升高CHF患者血浆sICAM-1、sVCAM-1水平,接近日常生活活动强度的运动训练可降低该二者水平。

Objective: To investigate the effects of rehabilitation exercise on plasma levels of soluble intercelluar adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1) and sE-selectin in patients with congestive heart failure (CHF). Methods : The level of sICAM-1,sVCAM-1 and sE-selectin were detected respectively by means of ELISA before and after 6 min walk test (6 -MWT) in 23 cases with CHF and 20 healthy persons acted as control group. Eighteen cases with CHF were followed after one month of physical training. Results: The levels of sICAM-1, sVCAM-1 and sE-selectin in patients with CHF were significantly higher than those of control group(P <0. 05-<0. 01) ,and sICAM -1 and sVCAM- 1 were related to severity of heart failure(P<0. 05) according to New york heart association (NYHA) classification. Rehabilitation exercise decreased the levels of sICAM - 1 and sVCAM-1. in CHF patients either before or after 6 - MWT (P<0. 05) . Conclusion: The 6 -MWT can increase plasma soluble cell adhesion molecule levels in patients with CHF and exercise mimicking the patients day to day activities can decrease levels of sICAN-1 and sVCAM -1.