冠心病患者等长收缩训练的作用及机理

Effects and mechanism of isometric exercise training in patients with coronary artery disease

目的:验证等长收缩训练(IE)在冠心病康复中的疗效及机理。方法:40例冠心病患者分为IE组和动力性运动DE组。IE组每日进行IE体操和有氧训练,DE组每日进行有氧训练,每周均训练5次。两组治疗时间均为6周。测定训练前后心率、血压、体重、腰围、臀围,心电运动试验,空腹血糖、血脂和二维超声心动图,并用放免法测定前后内啡肽(强啡肽、β-内啡肽、亮氨酸脑啡肽)的变化。结果:①两组均引起体质改善,但IE组腰围下降、肌力增加、最大运动时间增加和TG下降更为明显。②IE组定量运动时心血管反应下降。③IE组脑啡肽和β-内啡肽明显增加。结论:冠心病患者IE训练可以安全有效地改善体质,提高最大运动能力,降低定量运动心血管反应,其机理与L-EK和β-END增加有关。

Objective:To testify the effect and mechanism of isometric exercise(IE)training in patients with coronary artery disease(CAD).Method:Forty CAD patients were divided into IE group(n=20)and dynamic exercise(DE)group(n=20).Patients in the IE group were required to perform isometric exercise and aerobic exercise.DE group per-formed aerobic training5sessions per week.Body weight(BW),waist and gluteal circumference,ECG exercise test-ing,2-dimension echocardiography,fasting blood sugar(FBS),TG,Chol,HDL,LDL,Leu-Enkephalin(L-EK),β-Endorphin(β-END)and Dynphin A(DYN)in plasma were assessed before and after training.Result:①The physical fitness in both groups improved significantly.The beneficial change in waist circumference,TG,muscle strength and maximal exercise time were more significant in IE group than DE group.②Attenuation of cardiovascular response at given load was more remarkable in IE group than DE group.③L-EK andβ-END increased significantly in IE group only.Con-clusion:IE is safe and effective to increase maximal endurance and attenuate the cardiovascular response to given load exercise in CAD patients,which is attributed partially to the elevation of EOPs release.Author's address The First Affiliated Hospital of Nanjing Medical University,210029