个体化运动整体方案强化管控对长期慢性疾病患者静息桡动脉脉搏波的影响  

Effect of intensive treatment with holistic program of individualized exercise on resting radial artery pulse wave in patients with long-term chronic diseases

作　　者：宋雅 孙兴国 郝璐[1] 张也 台文琦 刘方 冯静[3] 王继楠[1] 曹建忠 谢友红 SONG Ya;SUN Xing-guo;HAO Lu;ZHANG Ye;TAI Wen-qi;LIU Fang;FENG Jing;WANG Ji-nan;CAO Jian-zhong;XIE You-hong(Department of Cardiopulmonary Rehabilitation,The Affiliated Rehabilitation Hospital of Chongqing Medical University,Chongqing,400000,China;Department of Functional Testing,National Center for Cardiovascular Disease,Fuwai Hospital,Chinese Academy of Medical Sciences;Department of Cardiology,Beijing Rehabilitation Hospital Affiliated to Capital Mediacal University;Department of Cardiology,Beijing Rehabilitation Hospital)

机构地区：[1]重庆医科大学附属康复医院心肺康复科,重庆400000 [2]国家心血管病中心中国医学科学院阜外医院功能检测科 [3]首都医科大学附属北京康复医院心内科 [4]北京第一康复医院心内科

出　　处：《中华高血压杂志》2022年第1期45-50,共6页Chinese Journal of Hypertension

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);北京协和医学院教学改革项目(2018E-JG07);北京协和医学院-国家外国专家局外国专家项目(T2017025,T2018046,G2019001660)。

摘　　要：目的观察曾被常规治疗且经个体化运动整体方案管控后的长期慢性疾病(慢病)患者的静息桡动脉脉搏波情况。方法2019年1月至2020年5月对无特定运动习惯的健康人20名(正常对照)、仅常规治疗未强化管控的长期慢病患者20例(未强化管控组)及常规治疗且经个体化运动整体方案管控的长期慢病患者20例(强化管控组)行静息桡动脉脉搏波检测,采集记录连续50 s左侧桡动脉脉搏波数据,定性及定量分析桡动脉脉搏波波形及主要指标的异同:波峰明显重搏波出现率、主波波峰点幅值(Y_(P1))、重搏波波谷点幅值(Y_(PL))、重搏波波峰点幅值(Y_(P2))、主波升支斜率(S_(1))、重搏波升支斜率(S_(2))和重搏波幅度(Y_(P2)-Y_(PL))。结果(1)从桡动脉脉搏波波形分析,强化管控组患者与正常对照具有相似的重搏波特征且主波高而窄,不同于无明显重搏波特征且主波低而圆润的未强化管控患者。(2)从主要指标分析,与正常对照比较,未强化管控患者波峰明显重搏波出现率较高,强化管控组患者波峰明显重搏波出现率低于未强化管控组(正常对照组94.7%比未强化管控组24.5%比强化管控组95.4%,χ^(2)=1810.093,P<0.001);与正常对照组比较,未强化管控组Y_(P1)、S_(1)、S_(2)和Y_(P2)-Y_(PL)较低且Y_(PL)较高(均P<0.05),与未强化管控患者比较,强化管控组患者Y_(P1)、S_(1)、S_(2)和Y_(P2)-Y_(PL)较高且Y_(PL)较低(均P<0.05),强化管控组患者上述指标与正常对照组差异无统计学意义(P>0.05)。结论强化管控过的长期慢病患者的静息桡动脉脉搏波与健康年轻人相似,主波波峰高而窄,基本上均是波峰明显的重搏波且重搏波幅度大、波谷低;而与未强化管控患者显著不同。强化管控后长期慢病患者主波和重搏波的改善或可作为慢病有效治疗的参考指标之一。Objective To observe the resting radial artery pulse wave of patients with long-term chronic diseases who have been routinely treated and intensively managed by the holistic program of individualized exercise.Methods Twenty cases of healthy people without specific exercise habits(normal group),20 cases of long-term chronic disease patients who only received routine treatment and did not receive intensive treatment(non-intensive trentment group),and 20 cases of long-term chronic disease patients who received routine and intensive treatment by the holistic program of individualized exercise(intensive treatment group)were recruited from January 2019 to May 2020.The pulse wave data of their left radial artery were collected and recorded for 50 seconds.Then the similarities and differences of pulse waveforms and main indexes were analyzed qualitatively and quantitatively,including the proportion of the crest obvious dicrotic wave,main wave peak amplitude(Y_(P1)),dicrotic wave trough amplitude(Y_(PL)),dicrotic wave peak amplitude(Y_(P2)),main wave ascending branch slope(S_(1)),dicrotic wave ascending branch slope(S_(2)),dicrotic wave amplitude(Y_(P2)-Y_(PL)).Results(1)The patients received intensive treatment had similar dicrotic wave characteristics with young healthy people,and had high and narrow main wave in the radial artery pulse waveform,which was similar with young healthy people,while different from patients without intensive treatment,who had no obvious dicrotic wave characteristics,and had low and round main wave in pulse waveform.(2)Compared with young normal people,the proportion of the crest obvious dicrotic wave in patients without intensive treatment was lower,and which was higher in patients recieved intensive treatment than in patients without intensive treatment(normal group 94.7%vs non-intensive trentment group 24.5%vs intensive treatment group 95.4%,χ^(2)=1810.093,P<0.001).Compared with young normal people,Y_(P1),S_(1),S_(2) and Y_(P2)-Y_(PL) in patients without intensive treatment were lower and

关 键 词：静息桡动脉脉搏波 重搏波 主波 强化管控 慢性疾病 

分 类 号：R443[医药卫生—诊断学]