个体化精准恒定功率运动前、后慢性病患者脉搏波波形特征改变初步分析  

Preliminary Analysis of Changes of Pulse Waveform before and after Individualized Constant Power Exercise

作　　者：李浩 孙兴国 张也 葛万刚 席家宁[2] 陈荣 张振英[2] 夏蕊 马铭欣 王冬 邹昱馨[1,5] 杨戈 冯静 于红[2] 姜立清[2] LI Hao;SUN Xingguo;ZHANG Ye;GE Wangang;XI Jianing;CHEN Rong;ZHANG Zhenying;XIA Rui;MA Mingxin;WANG Dong;ZOU Yuxin;YANG Ge;FENG Jing;YU Hong;JIANG Liqing(Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College,Beijing 100037,China;Department of Cardiopulmonary Rehabilitation,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China;Dalian Children's Hospital,Dalian 116000,China;Department of Cardiac Function,Rugao People's Hospital,Rugao 226500,China;Liaocheng People's Hospital,Liaocheng 252000,China;Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]中国医学科学院阜外医院,国家心血管病中心,北京协和医学院,心血管疾病国家重点实验室,国家心血管疾病临床医学研究中心,北京市100037 [2]首都医科大学附属北京康复医院心肺康复中心,北京市100144 [3]辽宁省大连市儿童医院,116000 [4]江苏省如皋市人民医院心功能科,226500 [5]山东省聊城市人民医院,252000 [6]河南省南阳市中心医院,473000

出　　处：《中国全科医学》2018年第30期3665-3671,共7页Chinese General Practice

基　　金：国家自然科学基金医学科学部面上项目(81470204);中国医学科学院国家心血管病中心阜外医院科研开发启动基金(2012-YJR02);国家高技术研究发展计划(863计划)课题(2012AA021009);首都临床特色应用研究(Z141107002514084);首都临床特色应用研究与成果推广(Z161100000516127)。

摘　　要：目的探讨个体化精准恒定功率运动对慢性病患者脉搏波波形特征的影响。方法选取2017年6月在首都医科大学附属北京康复医院接受本团队管理的慢性病(以血糖、血脂、血压异常为主)患者中的11例为慢病组,同期选取在中国医学科学院阜外医院学习的正常人8例为正常组。以心肺运动试验评估制定个体化精准恒定功率运动处方,每天运动30 min,在运动前和运动后5、15、30、40 min测量其桡动脉脉搏波波形。对受试者脉搏波原始数据用Origin作图,对桡动脉脉搏波的上升、下降、切迹或平台等波形特征及其运动前后变化进行定性分析,并比较两组运动前、后切迹出现率。结果运动前慢病组切迹出现率低于正常组(P=0.010)。运动后两组脉搏波均较运动前的波峰变高、波形变窄。运动后5、15、30、40 min慢病组切迹出现率同运动前比较,差异无统计学意义(P>0.05),正常人切迹出现率始终为100.0%;运动后5、15、30、40 min慢病组切迹出现率与正常组比较,差异无统计学意义(P>0.05)。结论个体化精准恒定功率运动可改变脉搏波波形,其可能作为运动疗法有效管控慢性病的指标,其机制有待进一步研究。Objective To investigate the effect of individualized constant power exercise on pulse wave in patients with chronic diseases.Methods Eleven patients with chronic diseases(blood sugar,blood lipids,and blood pressure abnormalities)managed by our team were enrolled as the patient group in the Beijing Rehabilitation Hospital affiliated to Capital Medical University in June 2017 and eight normal persons were enrolled in the Fuwai Hospital,Chinese Academy of Medical Sciences as the normal group during the same period.The individualized quantitative exercise prescription was developed by cardiopulmonary exercise test,and the radial artery pulse wave was measured before and at 5,15,30,40 min after exercise,with 30 minutes of exercise every day.The original data of pulse wave of subjects was plotted with Origin,and the waveform characteristics of the rise,fall,notch or plateau of the radial artery pulse wave and its changes before and after the exercise were qualitatively analyzed,and the pre-and post-existing notch occurrence rates were compared in two groups.Results The notch occurrence rate of the patient was lower than that of normal group(P=0.010)before exercise.After exercise,the pulse wave waveform of both groups became higher and narrower.There was no statistical significance in notch occurrence rate of patient group before and after 5 min,15 min,30 min,40 min of exercise(P>0.05).There was no significant difference in the notch occurrence rate between the patient group and the normal group after 5 min,15 min,30 min,40 min of exercise(P>0.05).Conclusion Individualized constant power exercise can change the pulse wave waveform,which may be an effective indicator for exercise control of chronic diseases and hypertension,but its mechanism needs further study.

关 键 词：运动疗法 心肺运动试验 脉搏 慢性病 高血压 糖尿病 高脂血症 

分 类 号：R455[医药卫生—运动医学]