美托洛尔联合有氧运动改善高血压患者骨骼肌功能性抗交感及运动能力的疗效观察  

Metoprolol combined with moderate-intensity aerobic exercise improves skeletal muscle functional sympatholysis and the exercise capacity of mildly hypertensive men

作　　者：崔彩[1] 吴翠平[2] 王晨宇[3] Cui Cai;Wu Cuiping;Wang Chenyu(Henan Technical College of Construction,Zhengzhou 450064,China;Zhengzhou University Hospital,Zhengzhou 450007,China;Zhengzhou University of Aeronautics,Zhengzhou 450015,China)

机构地区：[1]河南建筑职业技术学院,郑州450064 [2]郑州大学医院,郑州450007 [3]郑州航空工业管理学院,郑州450015

出　　处：《中华物理医学与康复杂志》2019年第7期526-531,共6页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨单独服用美托洛尔以及美托洛尔联合中等强度有氧运动对男性轻度原发性高血压患者骨骼肌交感缩血管反应、功能性抗交感及运动能力的影响。方法采用随机数字表法将30例男性轻度(1级)原发性高血压患者分为药物组及观察组。药物组仅服用美托洛尔,观察组在服用美托洛尔同时辅以有氧运动,运动强度为50%~70%最大摄氧量(VO2max)水平,每次运动30~45 min,每周运动3~5次。于治疗前、治疗12周后利用递增负荷运动试验测定患者最大摄氧量(VO2max)、峰值功率(PP)并描计运动过程中主观疲劳感觉(RPE)曲线,利用多普勒超声仪测定安静时和握力运动时冷加压实验(CPT)诱发的前臂血管电导(FVC)。交感缩血管参数采用CPT前、后FVC变化率(%FVC)表示,功能性抗交感(即肌肉收缩抑制交感缩血管反应的能力)参数采用握力运动时%FVC与安静时%FVC的差值(△%FVC)表示。结果治疗后观察组握力运动时%FVC\[(-15.4±5.9)%\]较安静时%FVC\[(-31.8±7.2)%\]明显下降(P<0.05),治疗后观察组△%FVC\[(15.8±7.1)%\]、VO2max\[(43.9±4.1 mL/kg/min)\]和PP\[(212.7±22.7)W\]均较治疗前明显增加(P<0.05),递增负荷运动试验中RPE曲线右移。治疗后药物组握力运动时%FVC\[(-22.2±8.6)%\]与安静时%FVC\[(-28.3±9.0)%\]无明显差异(P>0.05),治疗后药物组△%FVC\[(7.6±5.5)%\]、VO2max\[(38.8±4.1)mL/kg/min\]与治疗前无明显差异(P>0.05),PP\[(172.6±22.0)W\]较治疗前明显降低(P<0.05),RPE曲线左移。结论美托洛尔联合中等强度有氧运动能显著改善男性轻度原发性高血压患者骨骼肌功能性抗交感,提高运动能力,减轻服用美托洛尔造成的运动不耐受。Objective To investigate the effect of metoprolol and metoprolol combined with moderate intensity aerobic exercise on the sympathetic vasoconstriction response of skeletal muscle, functional sympatholysis and the exercise capacity of hypertensive men. Methods Thirty men with mild (stage 1) essential hypertension were divi-ded into a drug group and an observation group. The drug group received only metoprolol while the observation group took metoprolol and performed aerobic exercise (intensity 50-70% of VO2max, 30-45 min/time, 3-5 times/week) for 12 weeks. Before and after the experiment, the subjects′ maximum oxygen uptake (VO2max), peak power (PP) as well as a rating of perceived exertion (RPE) curve during exercise were determined using the graded exercise test. Forearm vascular conductance (FVC) induced by the cold pressor test was measured using Doppler ultrasound at rest and during a handgrip exercise. Sympathetic vasoconstriction response was manifested by the rate of change in the conductance (%FVC) before and after the cold pressor test. Functional sympatholysis (the ability of muscle contractions to inhibit sympathetic vasoconstrictor response) was quantified using the difference in the %FVC values (△%FVC) between the handgrip exercise and at rest. Results After the treatment,%FVC during the handgrip exercise was lower than at rest in the observation group.△%FVC had increased significantly, as had VO2max and PP. The RPE curve during a graded exercise test shifted to the right in the observation group, but there was no significant change in the other observations. In the drug group, PP had decreased significantly and the RPE curve had shifted to the left. Conclusion Metoprolol can better improve functional sympatholysis and enhance exercise capacity when it is combined with moderate intensity aerobic exercise. That will alleviate any exercise intolerance in men with mild hypertension caused by taking metoprolol alone.

关 键 词：高血压 美托洛尔 有氧运动 交感缩血管反应 功能性抗交感 运动能力 

分 类 号：R544.11[医药卫生—心血管疾病]