不同类型运动训练对抑制心肌梗死患者内皮依赖性舒张的试验研究

Experimental study of different types of exercise training on inhibiting endothelium-dependent relaxation in patients with myocardial infarction

目的:通过测量内皮素水平、血流介导的舒张功能,血管性血友病因子(vWF因子)水平变化评估不同类型运动训练对内皮功能的影响。方法:招募48例受试患者(年龄≥60岁)随机分为4组,A1-A3组分别接受有氧训练、抗阻训练、联合训练,A4组不训练,观察前后24周肱动脉血管的反应性和中断训练后血管内皮功能变化规律。结果:在基准水平血流介导的扩张情况,A1组:4.6±2.5%,A2组:4.3±1.7%,A3组:4.3±3.8%,A4组:4.1±2.5%。经过24周运动训练之后,A1组:9.8±2.4%,A2组:10.0±2.8%,A3组:10.6±3%;较基线值水平血流介导扩张呈现非常显著提高(P<0.01)。A4组(4.4±2.8%)随访值比例也有所上升(P<0.05),与试验组比较程度要小得多。在A1-A3组中的vWF因子水平在中断训练后下降了16%(P<0.01),逐渐恢复基准水平,A4组保持不变。结论:心肌梗死患者中,内皮功能的改善与训练类型无关,中断训练1个月后内皮功能变化会逐渐消失。

Objective:The effects of different types of exercise training on endothelial function were evaluated by measuring endothelin level,blood flow-mediated diastolic function and von Willebrand factor(vWF)factor level.Method:Forty-eight patients(aged over 60 years)were randomly divided into four groups.Group A1-A4 received aerobic training,resistance training,combined training or no training,respectively.After 24 weeks of withdrawal training,the reactivity of brachial artery vessels and the changes of vascular endothelial function were observed.Result:At baseline level,the blood flow-mediated dilations were:A1(4.6±2.5%),A2(4.3±1.7%),A3(4.3±3.8%),A4(4.1±2.5%).After 24 weeks of exercise training,the dilations were A1(9.8±2.4%),A2(10.0±2.8%),A3(10.8±3%),increasing significantly when compared with those of baseline level(P<0.01).The proportion of follow-up values in group A4(4.4±2.8%)also increased,but to a much smaller extent.The level of vWF factor in A1-A3 group decreased by 16%(P<0.01)after withdrawal training,and gradually returned to the baseline level,while that in A4 group remained unchanged.Conclusion:The improvement of endothelial function in patients with myocardial infarction is not related to the type of training.The change of endothelial function will gradually disappear after one-month withdrawal training.