长期有氧运动改善中年原发性高血压患者功能性抗交感活性

Long-term Aerobic Exercise Training Improved Activity of Functional Sympatholysis in Patients of Middle-aged Essential Hypertension

目的探讨有氧运动对中年原发性高血压患者功能性抗交感活性的影响。方法 15名原发性高血压患者(高血压组)以及15名年龄、身高、体重相匹配的正常血压者(正常血压组)自愿参加试验,2组均进行强度为50~70%VOmax、共12周的有氧运动干预。分别与运动前后股动脉酪胺灌注、单腿伸膝实验以及股动脉灌注酪胺+单腿伸膝实验时测定血浆去甲肾上腺素(NA)含量以及下肢血液动力学参数,后者主要包括股动脉血流量(FABF)和股动脉血管电导(FAVC)。结果运动前:灌注酪胺时,正常血压组和高血压组FABF、FAVC显著性下降(P<0.05),血浆NA显著性升高(P<0.05);单腿伸膝实验时,高血压组FABF和FAVC低于正常血压组(P<0.05),血浆NA无显著性变化(P>0.05);酪胺灌注+单腿伸膝运动实验时,高血压组和正常血压组灌注酪胺时的FABF、FAVC均低于未灌注时(P<0.05),血浆NA则高于未灌注时。运动后:酪胺灌注时,正常血压组和高血压组FABF和FAVC下降幅度均较运动前显著性降低(P<0.05);单腿伸膝运动实验中,高血压组FABF和FAVC与正常血压组无显著性差异(P>0.05);酪胺灌注+单腿伸膝运动实验中,高血压组和正常血压组灌注酪胺时的FABF和FAVC与未灌注时无显著性差异(P>0.05),高血压组酪胺灌注时的FABF和FAVC高于运动前(P<0.05);血浆NA均无显著性变化(P>0.05)。结论长期运动训练可降低中年高血压患者和血压正常者安静时的α-肾上腺素能神经兴奋反应性,并改善肌肉收缩时的功能性抗交感活性。

Objective Tu investigate the effects of aerobic exercise training on activity of functional sympatholysis in middle -aged essential hypertension. Methods Fifteen essential hypertensive indivktuals （hypertension group） and fifteen age, height anti weight matched,normotensive individuals （normotension group） voluntarily participated in this study. Plasma no- radrenalin （NA） content and leg haemodynamics mainly including femoral arterial blood flow （FABF） and femoral artery vascular conductance （FAVC） were measured before anti after 12 weeks of aerobic exercise （ training intensity： 50 - 70% VOmax ） during femoral arterial tyramine intusinn, one - legged knee extension test and femoral arterial tyramine infusion ＋ one -legged knee extension test. Results Before training： in arterial tyramine infusion,FABF and FAVC were reduced and plasma NA increased in both groups （P 〈0. 05） ;in one -legged knee extension test,FABF and FAVC were lower in hyper- tension gronp than nnrmotension group （P 〈0. 05 ）, plasma N A had no significant change （P 〉 0. 05 ） ;during arterial tyra- mine infusion ＋ one -legged knee extension test, FABF and FAVC were reduced while plasma NA increased in both groups （ P 〈 0. 05 ）. After training： in arterial tyramine infusion, reduction of FABF and FAVC was lower than pre - exercise in bothgroups （ P 〈 0. 05 ） ; in one - legged knee extension test, FABF and FAVC were was similar in hypertension and normotension group （ P 〉 0. 05 ） ; during arterial tyramine infusion ＋ one - legged knee extension test, FABF and FAVC were similar in both groups（P 〉0. 05） while FABF and FAVC were higher than pre -exercise in hypertension group （P 〈0.05） ;there was no change in plasma NA （ P 〉 0. 05 ）. Conclusion Long - term aerobic exercise training reduced α - adrenergic responsive- ness at rest and improved activity of functional sympatholysis during muscle contraction in both middle - aged essential hyper- tension patients and normotensive individuals.