12周有氧运动对缓解期溃疡性结肠炎患者氧化应激、炎症因子和运动能力的影响

Effects of 12-week Aerobic Exercise on Oxidative Stress,Inflammatory Factors and Exercise Capacity in Patients with Remission Stage of Ulcerative Colitis

目的:观察12周有氧运动对缓解期溃疡性结肠炎(UC)患者临床疗效、氧化应激、炎症因子和运动能力的影响,为制定有针对性的运动处方提供依据。方法:36名UC患者随机分为运动组和对照组。运动组进行为期12周的有氧运动,对照组保持日常生活习惯。分别于实验前后测定血浆丙二醛(MDA)、谷胱苷肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α),利用递增负荷运动实验测定最大耗氧量(VO2max)并描计运动过程中的心率(HR)曲线、主观疲劳感觉(RPE)曲线和血乳酸曲线。实验后对疗效、不良反应以及病情复发进行评价。结果:两组受试者基线变量之间均无显著性差异(P>0.05),组间具有可比性。实验后,运动组安静HR降低了7b/min(P<0.01),VO2max升高了20.7%(P<0.01),血浆MDA、IL-6和TNF-α分别降低了30.6%(P<0.01)、63.8%(P<0.01)和48.1%(P<0.01),GSH-Px和SOD分别升高了20.5%(P<0.01)和24.4%(P<0.01)。递增负荷运动实验中HR曲线、RPE曲线以及血乳酸曲线均发生右移。实验后运动组总有效率显著高于对照组(90.0%vs 62.5%,P<0.05),复发率显著低于对照组(5.6%vs 36.4%,P<0.05),不良反应率在两组无显著性差异(30.0%vs25.0%,P>0.05)。结论:低强度(50%VO2max)有氧运动作为UC患者缓解期的维持治疗是安全而有效的,能显著降低复发率并提高运动能力,其机制与长期运动诱导的抗炎、抗氧化效应有关。

Objectives： To observe the effects of 1Z-week aerobic exercise on clinical curauve effect, oxidative stress, inflammatory factors and exercise capacity in patients with remission stage of Ulcerative Colitis （UC） in order to provide evidence for formulating special exercise prescription. Methods：Thirty-six UC patients were randomly divided into exercise group and control group. Subjects of exercise group performed a 12-week aerobic training prescription and control group maintained their daily life style. Plasma malondialdehyde （MDA）, glutathione peroxidase （GSH-Px）, superoxide dismutase （SOD）, interleukin-6 （IL-6）, tumor necrosis fac- tor- （TNF-a） and maximal oxygen intake （VO2max） by graded exercise test and heart rate curve, ratings of perceived exertion （RPE） curve, blood lactic acid curve during exercise test were measured before and after the experiment. Curative effect, adverse reaction and illness re lapse were evaluated after test. Results：There were no significant difference of baseline varia bles between the two groups （P〈0.05）, which had comparability between groups. After the experiment, rest heart rate reduced by 7b/min （P〈0.01）, VO2 max increased by 20.7 % （P 〈0.01）, plasma MDA, IL-6 and TNF-a decreased by 30.6%（P〈0.01）, 63.8% （P〈0. 01） and 48. 1 %（P〈 0. 01 ） respectively, GSH-Px and SOD elevated by 20. 5 %0 （P 〈0. 01） and 24.4 % （P〈0.01） respectively in exercise group. Heart rate curve, ratings of per ceived exertion （RPE） curve, blood lactic acid curve during exercise test shifted right in exer- cise group. Compared with control group, total effective rate of exercise group was higher （90.0% vs 62.5%,P〈0. 05）, relapse rate was lower （5. 6% vs 36.4%,P〈0. 05）,but adverse reaction rate had no statistical difference （30.0 % vs 25.0 %, P〈0.05）. Conclusion： Low intensity （50 %VO2 max） aerobic exercise as maintenane therapy for patients with remission stage of UC was safe and effective and significantly reduced relapse rate and enhanced ex- ercise capacity. The mechanism was related to long-term exercise induced antiinflammatory and anti-oxidant effects.