基于阈值的个体化运动处方在代谢综合征中的临床应用进展

Progress in clinical application of individualized exercise prescription based on threshold in metabolic syndrome

代谢综合征(MS)患者存在潜在的心血管疾病风险,日渐受到公众和医学界的关注。研究表明,规律的体育锻炼能够有效调节血压、血糖与血脂等代谢指标,在降低心血管疾病风险、改善患者预后方面起到了积极作用,而运动强度被确定为运动干预中降低心血管死亡风险和全因死亡率的最重要方面,因此设计既科学又满足个体差异的运动处方成为研究的焦点问题。当前临床研究大部分是以百分比的运动强度作为MS患者标准化运动处方的制定依据,而以心肺运动试验(CPET)为基础的个体化阈值制定的运动强度的研究仍然较少。CPET表明,个体化运动处方可有效降低MS患者的身体成分指标、血压及血糖,改善心肺功能,提高其运动耐力和生活质量。文章综述了依据CPET中的阈值指标制定不同强度的个体化运动方案,分析其对MS患者及亚组人群的干预效果及可能存在的机制,为MS患者个性化运动处方的制定和实施提供一定的参考依据,也为深入开展个体化运动干预MS的研究提供借鉴。

Patients with metabolic syndrome(MS)are at potential risk for cardiovascular disease and have received increasing public and medical attention.Studies have shown that regular physical exercise can effectively regulate meta-bolic indicators such as blood pressure,blood sugar and blood lipids,and play a positive role in reducing the risk of cardio-vascular disease and improving the prognosis of patients.Exercise intensity has been identified as the most important as-pect in reducing the risk of cardiovascular death and all-cause mortality in exercise intervention.Therefore,the design of exercise prescription which is both scientific and satisfying individual differences has become the focus of research.Most of the current clinical studies are based on the percentage of exercise intensity as the basis for the formulation of standard-ized exercise prescription for MS patients,while the studies on the individualized threshold of exercise intensity based on cardiopulmonary exercise test(CPET)are still few.CPET has shown that individualized exercise prescription can effec-tively reduce body composition index,blood pressure and blood glucose,improve cardiorespiratory function,exercise en-durance and quality of life in MS patients.This paper reviewed the development of individualized exercise programs with different intensification according to threshold indexes in CPET,analyzed the intervention effects and possible mechanisms for MS patients and subgroups,and provided certain reference for the formulation and implementation of personalized exer-cise prescriptions for MS patients,and also provided references for in-depth research on individualized exercise intervention for MS.