运动对不同CVD风险等级人群干预效果的研究

Study on Intervention Effect of Exercise on People with Different CVD Risk Levels

研究在不同心血管风险等级的人群中,运动干预对血压、血糖和血脂的影响。研究方法:招募慢性病患者150例,根据心血管危险程度分为健康、低危、中危三大组,每组中再依据体力活动随机分为健康未达标组(HNS)、健康达标组(HRS)、低危未达标组(LNS)、低危达标组(LRS)、中危未达标组(MNS)和中危达标组(MRS)共6组,受试者同时参与集体运动干预。观察干预前后各组SBP、DBP、FBG、HbA1c、TC、LDL-C、HDL-C和TG指标的变化。结果表明:(1)24周后,19例受试者的心血管风险等级从低危降至健康,21例由中危降至低危;(2)LNS组、MNS组和所有达标组的SBP和DBP均出现显著性下降(P<0.05);(3)各组FBG和HbA1c均出现不同程度下降,其中达标组出现显著性下降(P<0.05);(4)各组血脂均出现不同幅度下降,所有达标组的TC、LDL-C和HDL-C均得到显著改善(P<0.05),MRS组的TG出现显著性下降(P<0.05);(5)未达标组中,SBP和DBP变化幅度呈阶梯式增加,血糖和血脂的改善幅度变化相差不大;达标组中,除HDL-C和TG外各指标变化幅度呈阶梯式增加。结论:(1)通过中等强度的有氧运动可以改善血压、血糖和血脂等相关危险因素,从而降低不同心血管风险人群的危险等级,其中心血管中危人群参与运动后获得的健康效益最高;(2)运动对心血管危险因素的改善程度主要受运动总量的驱动,除此之外还与心血管危险等级和基线水平有关。

Objective:To study the effects of exercise intervention on blood pressure,blood sugar and blood lipids in people with different cardiovascular risk levels.Methods:150 patients with chronic diseases were recruited and divided randomly into 6 groups:Health and not up to standard group(HNS),Health and reach the standard group(HRS),Low-risk and not up to standard group(LNS),Low-risk and reach the standard group(LRS),Middle-risk and not up to standard group(MNS),Middle-risk and reach the standard group(MRS).All the subjects participated in the collective exercise intervention of 24 weeks.SBP,DBP,FBG,HbA1c,TC,LDL-C,HDL-C and TG were observed before and after intervention.Results:(1)After 24 weeks,a total of 19 participants dropped from low cardiovascular risk to cardiovascular health,and a total of 21 participants dropped from middle-risk to low-risk;(2)SBP and DBP of LNS group,MNS group and all the standard groups were significantly decreased(P<0.05);(3)FBG and HbA1c in each group decreased to varying degrees,among which the up-to-standard group showed a significant decrease(P<0.05);(4)The blood lipids of each group decreased in different degrees.TC,LDL-C and HDL-C of all the standard groups were significantly improved(P<0.05),and the TG of the MRS group decreased significantly(P<0.05);(5)In the not up to standard group,the changes of SBP and DBP increased in a step-by-step manner,while the changes of blood glucose and blood lipid were similar;in the up-to-standard group,the changes of all indexes except HDL-C and TG increased in a step-by-step manner.Conclusion:(1)Moderate-intensity aerobic exercise can reduce the risk levels of different cardiovascular risk groups by reducing blood pressure,blood sugar and blood lipids and other related risk factors.Among them,the middle-risk group can obtain the highest health benefits after participating in exercise;(2)The degree of reduction of cardiovascular risk factors by exercise is mainly related to the total amount of exercise,cardiovascular risk level and baseline level.