【作者】 郭兰； 李河； 孙家珍； 汪萍； 冯建章；

【Author】 Guo Lan, Li He, Sun Jia Zheng, Wang Ping, Feng Jian Zhang

【机构】 广东省心血管病研究所；

【摘要】 目的 本研究旨在观察康复运动治疗对冠心病患者冠脉重建术后肢动脉内径的变化以进一步探讨运动治疗对冠心病患者内皮功能的作用.临床资料和方法 选择66例均经皮冠状动脉成形术后(PTCA)和/或冠搭桥术后(CABG)患者,其中PTCA患者56例,CABG后10例.66例患者按随机原则进入康复运动治疗组和常规治疗组各33例,两组患者均有常规用药且两组用药情况无差异,康复运动治疗组除常规治疗外还要接受按运动处方规定的12周的康复运动治疗,康复运动治疗方案按Ⅱ期运动方案制定,从最大运动量的65%开始,逐渐增加到80%,常规治疗组无康复运动治疗.观察疗程前后两组肱动脉内径的改变,脑动脉内径的测定通过肱动脉血管超声检查进行,测定反应性充血及喷雾硝酸甘油后血管内径的变化.反应性充血(FAD)及喷雾硝酸甘油后(GTN)血管内径的变化是以测量基础值的百分比表示(%).结果 两组的临床特征无统计学差异,具有可比性.康复运动治疗组12周疗程前、后以及两组疗程后的血管充血引起的肱动脉的内经的变化均有显著性差异(两者P<0.01),而常规治疗组疗程前、后血管充血引起的肱动脉的内经的变化无显著性差异(P>0.05).结论 冠心病冠脉重建术后患者经过12周康复运动治疗后肽动脉内径反应性血管充血功能明显改善,可以推断运动治疗可以改善冠心患者的血管内皮功能.更多还原

【Abstract】 Objective To investigate the effect of exercise training on artery endothelium function of patients, and address the relationship between Cardiac Rehabilitation exercise training and cardiovascular endothelial function.Subjects and Method 66 patients diagnosed as CAD after PTCA/CABG were enrolled in the study. 66 patients were randomly divided into retients in exercise training group got 12 weeks of exercise training and conventional care, The exercise program provided supervised conditioning for patients in rehabilitation department Guangdong Cardiovascular institute. Exercise prescription dependent on Phase II , the conventional group only had conventional care. We got the data at baseline and after 12 - week oftreatment from all patients. In each time, Arterial endothelia and smooth muscle function were studied no invasively by examining brachial artery responses to endothelium - dependent and endothelium - independent stimulation. The vessel diameter after reactive hyperemia (flow - mediated dilatation, FMD)and GTN administration was expressed as a percentage relative to the average diameter of the artery in the two resting scans( 100 % ) . Result FMD increased significantly after the training program in the CR exercise group, but conventional group had no chang( % ) . (P<0. 01) .Conclusion The change in FMD was only related to exercise training, and was independent of changes in baseline vessel size. The results showed that the, the research indicated the rehablil exercise training can improve endothelium function in patient with CAD.更多还原