缓步行走3km对血压心率的影响及其辅助降压的β内啡肽机制  

Three-kilometer low-speed walking was effective to lower short-term blood pressure and heart rate by increasing β-endorphin release in normotensive and hypertensive subjects

作　　者：王圣明 陈浥尘 陆琴 王建[2] 钟梅芳 陈红 赵军民 刘亿骁 邹沅芫 周佳玮 余俊贤 侯丽娜 山西恭辅 東野英明 山西博道 岡村椿树 WANG Sheng-ming;CHEN Yi-chen;LU Qin;WANG Jian;ZHONG Mei-fang;CHEN Hong;ZHAO Jun-min;LIU Yi-xiao;ZOU Yuan-yuan;ZHOU Jiwwei;YU Jun-xian;HOU Li-na;YAMANISHI Kyosuke;HIGASHINO Hideaki;YAMANISHI Hiromichi;OKAMURA Haruki(Department of Pharmacology and Chemical Biology,Shanghai J iao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院药理学与化学生物学系,上海200025 [2]厦门大学附属心血管病院心脏科 [3]上海市松江区卫生人才培训中心 [4]上海交通大学体育学教研室 [5]日本大阪府枚方市枚方療育園Harima Santorium病院

出　　处：《中华高血压杂志》2018年第10期953-961,共9页Chinese Journal of Hypertension

基　　金：国家自然科学基金资助项目(31171099,30971154)

摘　　要：目的比较正常血压年轻人低、中、高强度运动前后血压、心率的变化,观察缓步行走对高血压患者血压、心率的影响,探讨真实世界研究中低代谢当量(MET,<3 METs)的温和运动之辅助降压作用及其神经内分泌机制。方法本试验分两部分:第一部分共入选正常血压年轻人32名,分别进行低强度[缓步行走3km,耗时(49±4)min]、中等强度[快步行走3km,耗时(32±2)min]和高强度(健身房综合锻炼1h)运动,其中32人全部参加缓步行走,自我评估体力可耐受中等强度运动的24人参加快步行走,平素有健身房锻炼习惯的9人参加高强度运动,于运动前、运动后即刻,5及10min分别测静息血压、心率,并计算简易心肌耗氧量(收缩压×心率),检测尿常规、白蛋白、尿β内啡肽;第二部分共入选20～86岁高血压患者30例及年龄相似的正常血压对照24人,均进行缓步行走3km,步行前后测静息血压、心率、尿白蛋白、尿β内啡肽及生长激素。结果 (1)正常血压年轻人一次性缓步行走3km可显著降低运动后10min内的静息血压、心率与简易心肌耗氧量[运动后10min比运动前:收缩压(108±8)比(115±8)mm Hg,心率(70±11)比(76±12)次/min,简易心肌耗氧量(7225±1189)比(8690±1633)mm Hg·次/min,均P<0.01],而快步行走显著增加运动后即刻静息收缩压、心率与心肌耗氧量[运动后即刻比运动前:收缩压(115±11)比(110±10)mm Hg,心率(89±18)比(73±10)次/min,简易心肌耗氧量(9151±2374)比(7230±1368)mm Hg·次/min,均P<0.01];高强度运动1h显著增加运动后10min内的静息心率(P<0.01)及心肌耗氧(P<0.05),增加血尿和(或)尿白蛋白阳性率(P<0.05)。(2)高血压患者缓步行走3km可显著降低步行后10min内的静息收缩压、舒张压、心率与简易心肌耗氧量[运动后10min比运动前:收缩压(125±11)比(133±9)mm Hg,心率(73±10)比(78±12)次/min,简易心肌耗氧量(8469±2075)比(9523±2216)mm Hg·次/min,均P<0.01];缓步行�Objective To investigate the influence of low-speed walking on blood pressure and heart rate（HR） in normotensive and hypertensive subjects and its neuroendocrine mechanism in the real-world study. Methods The study included two parts. In the first part, 32 normotensive young volunteers were recruited, in which 32 subjects took part in the low-intensity exercise [a 3-kilometer low-speed walk for （49±4） mini, 24 subjects took part in the medium-intensity exercise [a 3 kilometer high speed walk for （32±2） mini and 9 subjects who have the gym exercise habits took part in high-intensity exercise （comprehensive exercise for 1 h in gymnasium）. The resting blood pressure and HR were measured in sitting position before walking （pre walk baseline values）, immediate and 5- as well as 10 min after walking （post-walk）. Estimated myocardial oxygen consumption was calculated as the HR timed by the systolic blood pressure. Urine samples were collected before and after walking for urine routine and determination of β-endorphin. In the second part, 30 hypertensives and 24 age matched （20-86 years） normotensive volunteers were enrolled and had a 3-kilometer low-speed walk. The pre walk/post-walk resting pres sure and HR taken as mentioned above. Urine samples were collected for β-endorphin and growth hormone determination. Results After 3-kilometer low-speed walking, resting blood pressure, HR and estimated myocardial oxygen consumption reduced significantly within 10 min post-walk in normotensive young volunteers EIO rain after walk vs pre walk values： systolic blood pressure （108±8） vs （115±8） mm Hg,HR （70±11） vs （76±12） beats/min, estimated myocardial oxygen consumption （7225±1189） vs （8690±16gg） mm Hg · heats/min, all P〈0. 01], hut increased immediately after high speed walking Eimmediately after walk vs pre walk values., systolic blood pressure （115±11） vs （110±10） mm Hg,HR （89±18） vs （73±10） heats/rain, estimated myocardial oxygen consumpti

关 键 词：缓步行走 血压 心率 高血压 Β内啡肽 运动代谢当量 心血管负荷 真实世界研究 

分 类 号：R544.1[医药卫生—心血管疾病]