长期习练太极拳对其发源地冠心病患者心脏重塑及心功能影响研究  

Effect of long-term practice of Taijiquan on cardiac remodeling and cardiac function in patients with coronary heart disease at its birthplace

作　　者：顾迎春 韩凌[1] 马娟[1] 孙兵兵[1] 赵智琛[1] 尹宁伟[1] 连鸿凯[1] 王东伟[1] Gu Yingchun;Han Ling;Ma Juan;Sun Bingbing;Zhao Zhichen;Yin Ningwei;Lian Hongkai;Wang Dongwei

机构地区：[1]郑州大学郑州中心医院心脏康复科,450007

出　　处：《中国疗养医学》2022年第4期350-353,共4页Chinese Journal of Convalescent Medicine

基　　金：河南省科技惠民计划《物联网下太极拳运动在社区冠心病患者中推广应用》(182207310003);省医学教育研究项目立项(wjlx2018293)。

摘　　要：目的通过对太极拳发源地陈家沟常驻居民实地调研,明确长期习练太极拳对既往确诊心肌梗死患者心脏结构及心功能的影响。方法本研究纳入既往发生过心肌梗死的陈家沟居民76例,其中10例被剔除,按练拳情况分为非练拳组(n=34)及坚持练拳组(n=32),从陈家沟健康居民中筛选健康未练拳居民,采用倾向性评分按1∶1匹配到非练拳组及坚持练拳组,分别为健康对照组1及健康对照组2,匹配容差为0.2。收集所有患者超声心动图结果如左房内径、左室舒张末期内径、右房内径、右室内径、室间隔厚度,左室后壁厚度、射血分数(LVEF)、舒张前期二尖瓣血流速度与舒张前期二尖瓣环运动速度比(E/e')、左房容积指数(LAVI)等指标,经统计学分析,明确长期习练太极拳对既往心肌梗死的陈家沟居民心脏结构及心功能的影响。结果非练拳组与健康对照组1及坚持练拳组与健康对照组2基线资料基本平衡,健康对照组1与健康对照组2心功能指标间差异无统计学意义。研究发现与健康对照组1相比,既往发生过心肌梗死患者心腔结构大小发生重塑,其中左室舒张末期内径(P=0.031)显著扩大,LAVI及E/e'亦显著升高;而长期习练太极拳后,与健康对照组2相比,心肌结构及心功能均未发现统计学差异指标。针对既往发生心肌梗死患者,与非练拳组相比,校正混杂因素后坚持练拳组可显著改善左房内径(P=0.030)及左室舒张末期内径(P=0.026),E/e'、LAVI也显著改善。结论冠心病患者心肌梗死后易发生心肌重塑,甚至影响心脏舒缩功能。而太极拳作为一项相对安全的有氧训练,长期习练太极拳可能延缓或抑制心肌重构的进展,对心脏舒张功能亦显著改善,为太极拳作为心脏康复运动疗法选择提供依据。Objective To determine the effect of long-term Taijiquan(Tai Chi Boxing)practice on the cardiac structure and cardiac function in patients with previously diagnosed myocardial infarction,through field investigation of permanent residents in Chenjiagou the birthplace of Taijiquan.Methods In this study,76 residents of Chenjiagou who had myocardial infarction in the past were included,of which 10 were excluded.According to the situation of boxing practice,they were divided into non boxing practice group(n=34)and boxing practice group(n=32).Healthy non boxing practice residents were selected from healthy residents of Chenjiagou.They were matched to non boxing practice group and boxing practice group according to 1∶1 propensity score,which were healthy control group 1 and healthy control group 2 respectively,The matching tolerance was 0.2.The echocardiographic results of all patients were collected,such as left atrial diameter,left ventricular end diastolic diameter,right atrial diameter,right ventricular diameter,ventricular septal thickness,left ventricular posterior wall thickness,ejection fraction(LVEF),ratio of pre diastolic mitral flow velocity to pre diastolic mitral annulus velocity(E/e'),left atrial volume index(LAVI)and other indicators.After statistical analysis,the effect of long-term practice of Taijiquan on cardiac structure and cardiac function of Chenjiagou residents with previous myocardial infarction was clarified.Results The baseline data of non boxing training group and healthy control group 1 and sticking boxing training group and healthy control group 2 were basically balanced.There was no significant difference in cardiac function indexes between healthy control group 1 and healthy control group 2.It was found that compared with healthy control group 1,the size of cardiac cavity in patients with previous myocardial infarction was remolded,in which the left ventricular end diastolic diameter(P=0.031)was significantly expanded,and the LAVI and E/e'were also significantly increased;After long-ter

关 键 词：太极拳 心肌梗死 心脏重塑 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]