【摘要】 目的　探讨运动对老年高血压病患者血流动力学和心血管体液因子的影响。方法　高血压组为 2～ 3级老年原发性高血压患者 3 4例 (药物控制 ) ,正常老年对照组 3 1例 ,作自感劳累分级法 (RPE) 11～13级疲劳程度的症状限制性运动平板试验 (改良的Bruce方案 ) ,试验前 3min、后 3min抽静脉血检测 ,观察运动过程的心率、血压、运动当量、运动时间及运动前、后的一氧化氮 (NO)、内皮素 (ET1)、血管紧张素Ⅱ(AngⅡ)、心房肽 (ANF)。结果　高血压组与对照组比较 ,平板运动前、运动峰时、恢复期 3min的心率、收缩压、舒张压及总的运动时间、峰时的运动当量 ,均P >0 .0 5 ,差异无显著性意义 ;运动后高血压组NO上升 48.7% ,对照组上升 5 2 .0 % ,均P <0 .0 5 ,差异有显著性意义 ;高血压组ANF运动前比对照组高 2 2 .0 % ,P =0 .0 0 6;2组运动前、后差值比较 ,NO、ET1、AngⅡ、ANF均P >0 .0 5。运动前收缩压与运动峰时、运动后收缩压正相关 (r =0 .64 8,0 .63 0 ,P <0 .0 0 1) ;运动前舒张压与运动峰时、运动后舒张压呈正相关 (r =0 .3 5 9,0 .5 2 0 ,P <0 .0 0 1) ;年龄与平板运动当量呈负相关 (r =0 .65 5 ,P <0 .0 0 1)。结论　老年高血压患者在药物控制下参加轻度疲劳程度的运动(相当于 8运动当量 )过程中 ,其心?更多还原

【Abstract】 Objective To study the effects of exercise on hemodynamic parameters and cardiovascular humoral factors in the elderly patients with hypertension. Methods The modified Bruce assessment (MBA) was employed in an essential hypertension (EH) group (group 1, n =34) composed by elderly EH patients and a control group (group 2, n =31) composed of normal subjects. Heart rate (HR),systolic and diastolic blood pressure (SBP、DBP), and the quantum and duration of exercise (QE, DE) were explored, while the serum concentrations of nitric oxide (NO), endothelin 1(ET1), atrial natriuretic factor (ANF) and AngiotensinⅡ(AngⅡ) were measured at 3 min before and after treatment. Results There were no significant differences between groups 1 and 2 with regard to HR, SBP, DBP, total DE and peak QE before and after treatment, in addition, at the peak of exercise ( P <0.05, respectively). After exercise, the concentrations of NO in groups 1 and 2 were significantly increased by 48.7% and 52.0%, respectively. Compared with that in group 2, the concentration of ANF in group1 was higher by 22.0% ( P =0.006) ; There were no significant differences between the concentrations of NO, ET1, AngⅡ and ANF before and after treatment in group 2 ( P >0.05). Pretreatment SBP and DBP were significantly and positively correlated with those at the peak of and after treatment ( r =0.648,0.630, P <0.001; r =0.359,0.520, P <0.001, respectively). QE was negatively correlated with age ( r =0.655, P <0.001). Conclusion The increase of HR, BP in elderly EH patients with drug therapies and low-grade exercise (8 MET) is similar to that of the healthy elderly. The changes of the concentration of NO may contribute to the alleviation of EH, and the changes of ET、AngⅡ and ANF were not obvious in short term.更多还原