有氧运动对脑卒中后慢性偏瘫患者下肢运动功能、血趋化素及代谢危险因素的影响  

Effects of aerobic exercise on lower limb motor function,serum chemerin and metabolic risk factors in patients with chronic hemiplegia after stroke

作　　者：李萍[1] 孔海霞[2] 李洪娟[2] LI Ping KONG Hai-Xia LI Hong-Juan(Department of Rehabilitation Medicine Department of Clinical Laboratory, the 5th Central Hospital of Tianjin, Tianfin 300450, China)

机构地区：[1]天津市第五中心医院康复医学科,天津市300450 [2]天津市第五中心医院检验科,天津市300450

出　　处：《中国动脉硬化杂志》2017年第4期393-397,共5页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨有氧运动对脑卒中后慢性偏瘫患者6 min步行距离、下肢运动功能及血趋化素水平等的影响。方法将108例脑卒中后慢性偏瘫患者按随机数字表法分为药物组、运动组和药物+运动组。药物组进行常规药物治疗;药物+运动组在药物治疗基础上,进行规律有氧运动;运动组仅进行有氧运动。采用功率自行车,每周3次,每次30 min,共治疗3个月。3组患者治疗3个月前后记录6 min步行距离、简式Fugl-Meyer运动功能量表下肢评分(FMA)、血压、体质量及身高,检测血趋化素、C反应蛋白、同型半胱氨酸及其他血生化指标。分析6 min步行距离与血趋化素水平的相关性。结果治疗3个月后,药物+运动组和运动组6 min步行距离、下肢FMA评分较同组治疗前明显增加(P<0.05,P<0.01),血趋化素、C反应蛋白、同型半胱氨酸、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、收缩压、体质量较同组治疗前明显下降(P<0.05)。药物+运动组治疗后6 min步行距离、下肢FMA评分明显高于治疗后药物组(P<0.05),药物+运动组C反应蛋白、空腹血糖、收缩压明显低于治疗后药物组(P<0.05)。治疗前血趋化素与6 min步行距离呈负相关(r=-0.279,P<0.01),多元逐步回归分析显示血趋化素下降与6 min步行距离的增加独立相关(P<0.05)。结论有氧运动可增加脑卒中后慢性偏瘫患者6 min步行距离、下肢FMA评分,提高下肢运动功能,并降低趋化素、C反应蛋白、同型半胱氨酸、空腹血糖、血脂及血压,从而改善生存质量、炎症状态及心脑血管代谢性危险因素。Aim To explore the effects of aerobic exercise on 6-minute walk distances （6MWD）, the lower limb motor function and serum chemerin in patients with chronic hemiparesis after stroke. Methods 108 patients with chronic hemiparesis after stroke were randomly divided into three groups： drug treatment group, drug treatment combined with aerobic exercise treatment group and aerobic exercise treatment group. Drug treatment group and drug treatment combined with aerobic exercise treatment group were given conventional medical therapy. The patients in drug treatment combined with aerobic exercise treatment group and aerobic exercise treatment group received regulear aerobic exercise using power bicycle each for 30 min, 3 times a week in 3 months. 6MWD, simplified Fugl-Meyer lower limb motor function assessment （FMA）, blood pressure, body mass and height were recorded, serum chemerin, C-reactive protein （CRP）, homocysteine, biochemistry were determined before and after the 3 months therapies. Results There were no significant difference among the three groups before treatment for 6MWD, FMA scores, serum chemerin, CRP, homocysteine, fasting blood glucose, blood lipids, blood pressure, body mass and body mass index （P〉0.05）. After 3 months treatment, 6MWD, FMA scores in drug treatment combined with aerobic exercise treatment group were significantly increased （P〈 0.01） , serum chemerin, CRP, homocysteine, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol （ LDLC）, systolic blood pressure and body mass in drug treatment combined with aerobic exercise treatment group were sig- nificantly decreased （P〈O.05） , 6MWD, FMA scores in aerobic exercise treatment group were significantly increased （P〈 0.01）, serum chemerin, CRP, homocysteine, fasting blood glucose, total cholesterol, LDLC, systolic blood pressure and body mass in aerobic exercise treatment group were significantly decreased （P〈0.05）, 6MWD, FMA scores in drug treat- ment combined with aerobic exer

关 键 词：有氧运动 脑卒中 趋化素 6MIN步行距离 下肢运动功能 

分 类 号：R493[医药卫生—康复医学]