肥胖人群微血管反应性的变化及运动干预  

Changes in microvascular reactivity and exercise intervention in obese patients

作　　者：肖哲 周术锋 朱欢 李锋 胡江平 Xiao Zhe;Zhou Shufeng;Zhu Huan;Li Feng;Hu Jiangping(School of Physical Education,Hubei University for Nationalities,Enshi 445000,Hubei Province,China;School of Physical Education,Guangxi University of Science and Technology,Liuzhou 545000,Guangxi Zhuang Autonomous Region,China;School of Physical Education,Guangxi Normal University for Nationalities,Chongzuo 532200,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]湖北民族大学体育学院,湖北省恩施市445000 [2]广西科技大学体育学院,广西壮族自治区柳州市545000 [3]广西民族师范学院体育学院,广西壮族自治区崇左市532200

出　　处：《中国组织工程研究》2023年第26期4223-4230,共8页Chinese Journal of Tissue Engineering Research

基　　金：2020年湖北省高等学校省级教学研究项目(2020550),项目负责人:朱欢;2021年湖北省教育厅科学研究计划重点项目(D20211901),项目负责人:朱欢;广西科技大学博士基金项目(校科博20S07),项目负责人:李锋;2022年度硒元产品营养与健康智能技术湖北省工程研究中心开放基金项目(PT082208),项目参与人:朱欢、肖哲、周术锋。

摘　　要：背景:在肥胖的发生与发展过程中,微血管功能障碍是关键因素。有氧运动不仅是减脂降重的有效方式,且能提高肥胖人群的微血管功能,但也有研究指出,抗阻运动、有氧联合抗阻运动、高强度间歇性运动等也能提高肥胖人群微血管反应性。目的:总结肥胖人群微血管反应性的变化特点以及不同运动方式对肥胖人群微血管反应性的干预效应、主要机制,为改善肥胖人群微血管功能提供理论依据。方法:以“肥胖、微循环、微血管、毛细血管、微血管反应性、微血管舒张、微血管血流量、运动、训练”为中文检索词;以“obesity,microcirculation,microvascular,capillary,microvascular reactivity,microvascular vasodilatation,microvascular blood flow,exercise,training”为英文检索词,分别在CNKI中国期刊全文数据库和PubMed数据库重点检索2000年1月至2022年8月的相关文献,最终纳入61篇文献进行综述。结果与结论:①静息状态下,肥胖人群微血管内皮细胞功能受损,导致微血管反应性下降,但当体内氧化应激、炎症反应不明显时,微血管反应性可能不发生显著改变。运动过程中尤其在大强度运动中肥胖人群微血管反应性明显下降,导致血流灌注不足。②持续6-12周、每周3-5次、运动强度为60%-80%最大心率的有氧运动能有效改善肥胖人群微血管反应性,但有氧运动改善肥胖人群微血管反应性的“剂量-效应”关系仍需进一步研究明确;持续6-12周、每周3次、运动强度为65%-80%1RM的有氧联合抗阻运动能有效改善肥胖人群微血管反应性,但仅以抗阻运动为干预方式时则需更长的干预时间;持续4-12周、每周两三次、运动强度为最大有氧运动强度及以上的高强度间歇性运动能改善肥胖人群微血管反应性,但由于相关研究较少,因此需进一步研究明确高强度间歇性运动对肥胖人群微血管反应性的干预效应。③调节NO/内皮BACKGROUND: Microvascular dysfunction is a key factor in the occurrence and development of obesity. Aerobic exercise is not only an effective way to reduce fat and body mass, but also can improve microvascular function in obese people. However, some studies have pointed out that resistance exercise, aerobic combined resistance exercise and high-intensity intermitient exercise can also improve microvascular reactivity in obese people.OBJECTIVE: To summarize the characteristics of microvascular reactivity in obese people and the intervention effects and main mechanisms of different exercise modes on microvascular reactivity in obese people, thereby providing a theoretical basis for improving microcirculation function in obese people.METHODS: CNKI and PubMed were searched for relevant literature published from January 2000 to August 2022 using “obesity, microcirculation, microvessels,capillary, microvascular reactivity, microvascular vasodilatation, microvascular blood flow, exercise, training” as Chinese and English search terms. Finally, 61articles were included for review.RESULTS AND CONCLUSION: In the resting state, the function of microvascular endothelial cells is impaired in obese people, which leads to the decrease of microvascular reactivity. However, when oxidative stress and inflammation are not obvious in vivo, microvascular reactivity may not change significantly. During exercise, especially in the process of high-intensity exercise, the microvascular reactivity of obese people is significantly decreased, resulting in blood perfusion insufficiency. Aerobic exercise lasting 6-12 weeks, 3-5 times per week, with the exercise intensity of 65%-80% maximal heart rate can effectively improve microvascular reactivity in obese people, but the “dose-response” relationship of aerobic exercise in improving microvascular reactivity in obese people still needs to be further studied. Aerobic exercise combined with resistance exercise lasting 6-12 weeks, 3 times a week, with the exercise intensity of 65%-80% 1

关 键 词：肥胖人群 微血管反应性 微血管血流量 运动干预 一氧化氮 内皮素 内皮细胞生长因子 

分 类 号：R455[医药卫生—运动医学] R318[医药卫生—治疗学] G804[医药卫生—临床医学]