冠心病患者运动后乳酸脱氢酶、肌酸激酶以及同功酶活性的变化趋势

Response profile of lactate dehydrogenase, creatine kinase and related isoenzyme activity to exercise in coronary heart disease patients

目的:观察冠心病患者在12周运动心脏康复程序前后心肌相关酶活性的反应趋势,为心脏康复程序的执行效果提供客观的评判信息。方法:61名男性冠心病患者(62.4±5.7岁)在12周运动心脏康复程序前后进行了递增负荷运动实验(跑台等级达到5.1级)。运动实验前、运动实验后即刻及运动实验后24小时由受试者肘前静脉取血进行了乳酸脱氢酶、乳酸脱氢酶同功酶-1、肌酸激酶、肌酸激酶同功酶-MB活性的测定。结果:1)康复程序前乳酸脱氢酶活性和乳酸脱氢酶同功酶-1活性运动后显著升高,但康复程序后升高的幅度有所减小,且24小时后酶活性已恢复到运动前水平;2)运动后乳酸脱氢酶同功酶-1活性与乳酸脱氢酶活性的比值无显著性变化;3)康复程序前肌酸激酶活性运动后显著升高,但康复程序后肌酸激酶活性运动后只有轻微升高,与康复程序前有显著差异;4)运动后肌酸激酶同功酶-MB活性以及肌酸激酶同功酶-MB活性与肌酸激酶活性的比值无显著性变化。结论:1)运动后冠心病患者血清酶活性增加的幅度要远低于临床上心肌受损的判定标准,且随身体机能的改善,酶活性增加的幅度有所减小,恢复的速率有所增快;2)这些酶活性的变化趋势为运动心脏康复程序的安全性和有效性提供了支持。

Objective： To investigate response profile of myocardium related enzymes activity to exercise in coronary heart disease patients, and provide objective information for assessing effects of an exercise-based cardiac rehabilitation program. Methods： 61 eoronary heart disease patients, aged 62.4± 5.7 years, performed a graded exercise test on a treadmill （reached 5.1 degree） both pre- and post- cardiac rehabilitation program. Blood samples were collected from the antecubital vein pre, post exercise and 24 hours later for lactate dehydrogenase （LDH）, lactate dehydrogenase isoenzyme 1 （LDH-1 ）, creatine kinase （CK） and creatine kinase polypeptide subunit MB （CK-MB） activity analysis. Resuhs： 1） The enzymes activity cff LDH and LDH-1 increased significantly post exercise pre-prograin, but this increase was lessened and restored to pre exercise level 24 hours later post program. 2） A non-significant change was observed for LDH- 1/LDH ratio post exercise. 3 ） The enzymes activity of CK increased significantly post exercise pre-program, but only a slight increase was seen post program. 4） A non-significant change was observed for CK-MB activity and CK-MB/CK ratio post exercise. Conclusion： ! ） The increasing range for serum enzymes activity induced by exercise in coronary heart disease patients was much less than that applied to ascertain myocardial injury clinically, and this increasing became lesser and restored faster with physical funetion of the patients improved. 2） The response profile of serum enzymes activity to exercise observed in the study provided a positive support for security and validity of the exercise-based cardiac rehabilitation program.