不同强度有氧运动对低高密度脂蛋白胆固醇血症的影响

The effects of aerobic exercise on low- and high-density lipoprotein cholesterol

目的观察低高密度脂蛋白胆固醇（HDL—C）血症有氧训练的效果。方法选取低HDL—C血症患者60例，根据训练强度的不同采用随机数字表法分为高、中、低强度3个训练组，每组患者20例。参照3组患者在症状限制性心电运动试验结果中所取得的最高心率制订运动强度，高强度训练组采用90％最高心率为靶心率的运动强度，中强度训练组采取70％最高心率为靶心率的运动强度，低强度训练组采取50％最高心率为靶心率的运动强度；3组患者均采用医用跑台（可随时监测心率）跑步的运动方式进行训练；3组达靶心率的运动时间均为每次20min；每组均隔天运动1次，疗程为2个月。记录3组患者训练前和训练2个月后（训练后）HDL-C值，并对其水平变化及3组患者训练后低HDL—C达正常值的例数进行比较。结果高强度、中强度和低强度训练组HDL—C水平分别由训练前的（0．81±0．22）mmol／L、（0．825-0．20）mmol／L和（0．795-0．25）mmol／L提高到训练后的（1．04_5-0．33）mmol／L、（1．035-0．37）mmol／L和（0．82±0．27）mmol／L；训练后，高强度和中强度训练组的HDL—C水平均显著高于组内训练前和低强度训练组训练后，差异均有统计学意义（P〈0．05），但高强度训练组与中强度训练组间HDL-C水平比较，差异无统计学意义（P〉0．05）。训练后HDL—C达正常值（HDL—C≥1．04mmol／L）例数分别为高强度训练组15例（15／20），中强度训练组13例（13／20），低强度训练组1例（1／20），且高、中强度训练组与低强度训练组比较，差异均有统计学意义（P〈0．01）。结论中、高强度有氧运动均能有效地改善低HDL—C血症患者的HDL—C水平，且中强度训练与高强度训练对其HDL—C水平和HDL—C达正常值例数的影响，差异无统计学意义（P〉0．05），建议临床采用中等强度有氧运动治疗低HDL—C血症。

Objective To observe the effects of aerobic exercise on low- and high-density lipoprotein cho- lesterol, and to investigate the relationship between exercise intensities and high-density lipoprotein Cholesterol （HDL-C） changes. Methods Sixty patients with low HDL-C were randomly allocated into a high intensity exer- cise group, a moderate intensity group or a low intensity group with ：20 in each group. According to each patient＇s maximal heart rate in a restrictive electrocardiogram exercise test, the different aerobic exercise intensities were for- mulated as follows. The target heart rate of the high-intensity training group was 90% of each subject＇s maximum heart rate; in the moderate-intensity group it was 70% ; in the low-intensity group it was 50% . All 3 groups jogged on a medical treadmill for 20 minutes every other day with their heart rates monitored at all times. They maintained the target heart rate for 20 minutes. The experiment lasted 2 months. Results In the high intensity group HDL- C increased from 0.81 - 0.22 to 1.04 ＋ 0.33 mmol/L after training; in the moderate intensity group it increased from0.82-＋0.20 to 1.03 ~0.37 mmol/L; in the low intensity group it increased from 0.79 ~0.25 to 0.82 ＋ 0.27 mmol/L. That increase in the low intensity group was not statistieally significant. After high intensity or mod- erate intensity training the HDL-C increases were statistically significant, but the difference between the groups was not. After training, in 15 eases among the high intensity group, 13 eases from moderate intensity group and in 1 ease from the low intensity group the HDL-C level achieved a normal value （ t〉 1.04 retool/L）. Comparing the high intensity group to the low intensity group or the moderate intensity group to the low intensity group, there were sig-nificant differences in the number of patients who achieved normal HDL-C readings, but there was no significant difference between high intensity group and the moderate intensity group. Conclusion Low intensity aerobic ex- ercise has no obvious effect on low HDL-C levels. High or moderate intensity aerobic exercise can effectively r/~ise the HDL-C level, but there is no significant difference in the fraction of patients reaching normal values between high and moderate intensity aerobic exercise. So moderate intensity is recommended for improving low levels of HDL cholesterol.