不同运动方式对高血压患者血压控制效果及糖脂代谢和自主神经功能的影响  

Effects of different exercise methods on blood pressure control,glucose-lipid metabolism and autonomic nervous function in patients with hypertension

作　　者：马肖 宋浩明[2] 刘双虎 关顺凯 陈嘉 李辉 靳刚强 孟庆兰 单厚雪 Ma Xiao;Song Haoming;Liu Shuanghu;Guan Shunkai;Chen Jia;Li Hui;Jin Gangqiang;Meng Qinglan;Shan Houxue(Medical Clinical Laboratory Center,Cangzhou People’s Hospital,Hebei Cangzhou 061001,China;Department of Cardiovascular Medicine,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China;Cardiovascular Department 5,Cangzhou People’s Hospital,Hebei Cangzhou 061002,China;ECG Room,Cangzhou People’s Hospital,Hebei Cangzhou 061002,China;Department Ⅱ of Cardiovascular,Cangzhou People’s Hospital,Hebei Cangzhou 061002,China;Department of Endocrinology,Cangzhou People’s Hospital,Hebei Cangzhou 061002,China;Department of Cardiovascular,Cangzhou People’s Hospital,Hebei Cangzhou 061002,China)

机构地区：[1]河北省沧州市人民医院医学临床检验中心,河北沧州061001 [2]同济大学附属同济医院心血管内科,上海200065 [3]河北省沧州市人民医院心血管内五科,河北沧州061002 [4]河北省沧州市人民医院心电图室,河北沧州061002 [5]河北省沧州市人民医院心血管内二科,河北沧州061002 [6]河北省沧州市人民医院内分泌科,河北沧州061002 [7]河北省沧州市人民医院心血管内三科,河北沧州061002

出　　处：《中国医刊》2024年第4期376-380,共5页Chinese Journal of Medicine

基　　金：2022年度河北省医学科学研究课题(20220318)。

摘　　要：目的探讨不同运动方式对高血压患者血压控制效果及糖脂代谢和自主神经功能的影响。方法选择2021年8月至2022年8月在河北省沧州市人民医院确诊的120例高血压患者作为研究对象,根据组间基线特征均衡可比的原则,采用随机数表法分为高强度组(采用高强度间歇运动)和低强度组(采用低强度持续有氧运动),每组60例。两组患者均接受常规降压干预后进行相应强度的运动,均持续干预8周。记录两组患者干预前后的血氧饱和度(SpO2)、疲劳程度[采用自主感觉累计分级表(RPE)评估]、血压控制情况[包括收缩压(SBP)和舒张压(DBP)]、自主神经调节功能[包括血压变异性(BPV)、心率变异性(HRV)、高频(HF)功率、低频(LF)功率和LF/HF比值]、糖脂代谢情况[包括空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)]、不良情绪[采用焦虑评分量表(SAS)评估]和生活质量[采用健康调查简表(SF-36)评估]并进行组间比较。结果干预后,高强度组患者的FPG、HbA1c、TC、TG和LDL-C水平均低于低强度组,差异有统计学意义(P<0.05);高强度组患者的SBP和DBP均低于低强度组,差异有统计学意义(P<0.05)。自主神经调节功能方面,高强度组患者HRV指标中的HF、LF均高于低强度组,LF/HF低于低强度组,差异有统计学意义(P<0.05);高强度组患者BPV指标中的HF高于低强度组,LF、LF/HF低于低强度组,差异有统计学意义(P<0.05)。高强度组患者的SpO2和RPE评分均高于低强度组,差异有统计学意义(P<0.05)。高强度组患者的SAS量表评分低于低强度组,SF-36量表评分高于低强度组,差异有统计学意义(P<0.05)。结论相较于低强度持续有氧运动,高强度间歇运动患者疲劳程度较重,但对患者血压有更好的控制效果,可改善患者自主神经功能和糖脂代谢水平,减轻负面情绪,提高生活质量。Objective To explore the effects of different exercise methods on blood pressure control,glucose-lipid metabolism and autonomic nervous function in patients with hypertension.Method A total of 120 patients with hypertension confirmed in Cangzhou People’s Hospital from August 2021 to August 2022 were enrolled and randomly divided into high-intensity group and low-intensity group,60 cases in each group.On basis of routine antihypertensive therapy,high-intensity group was given high-intensity intermittent exercise,while low-intensity group was given low-intensity continuous aerobic exercise for 8 weeks.The blood oxygen saturation(SpO2),fatigue degree[ratings of perceived exertion(RPE)],blood pressure control[systolic blood pressure(SBP),diastolic blood pressure(DBP)],regulatory function of autonomic nerve[blood pressure variability(BPV),heart rate variability(HRV),high-frequency(HF)power,low-frequency(LF)power,LF/HF ratio],glucoselipid metabolism[fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),lowdensity lipoprotein cholesterol(LDL-C)],negative emotions[self-rating anxiety scale(SAS)]and quality of life[the 36-item shot-form health status survey(SF-36)]in the two groups were recorded and compared before and after treatment.Result The levels of FPG,HbA1c,TC,TG and LDL-C in high-intensity group were lower than those in low-intensity group(P<0.05),SBP and DBP were also lower than those in low-intensity group(P<0.05).In terms of HRV,HF and LF in high-intensity group were higher than those in low-intensity group,while LF/HF was lower than that in low-intensity group(P<0.05).In terms of BPV,HF in high-intensity group was higher than that in low-intensity group,while LF and LF/HF were lower than those in low-intensity group(P<0.05).After treatment,SpO2 and RPE score in high-intensity group were higher than those in low-intensity group(P<0.05).SAS score in high-intensity group was lower than that in low-intensity group,and SF-36 score was higher than that in low-intensity g

关 键 词：运动 高血压 糖脂代谢 自主神经-功能 

分 类 号：R544[医药卫生—心血管疾病]