智能运动联合心脏康复对急性心力衰竭及Nrf2/NF-κB mRNA表达的影响  

Effects of intelligent exercise combined with comprehensive cardiac rehabilitation on acute heart failure and mRNA expression of Nrf2/NF-κB

作　　者：刘淑琴 张柳 赵婉婷 孙晓彤 杨澄 LIU Shuqin;ZHANG Liu;ZHAO Wanting;SUN Xiaotong;YANG Cheng(Cardiac Rehabilitation Center(Intensive Care Rehabilitation Department),Beijing Rehabilitation Hospital,Capital Medical University,Beijing,China,100144)

机构地区：[1]首都医科大学附属北京康复医院心脏康复中心(重症康复科),北京100144

出　　处：《分子诊断与治疗杂志》2025年第3期458-461,共4页Journal of Molecular Diagnostics and Therapy

基　　金：北京市卫生科技发展专项基金资助项目(2023-2-226)。

摘　　要：目的研究智能运动锻炼联合综合心脏康复对急性心力衰竭(AHF)及核因子-E2相关因子2(Nrf2)/对核因子-κB(NF-κB)mRNA表达水平的影响。方法选择2019年1月至2024年5月首都医科大学北京朝阳医院收治的AHF患者102例,随机分为观察组(51例,在常规治疗的基础上进行智能运动锻炼联合综合心脏康复)和对照组(51例,进行常规治疗)。干预前及干预4周后,采用纽约心脏病协会(NYHA)分级以及6分钟步行实验(6MWT)评价心功能,采用心超测定左心室射血分数(LVEF)和左室舒张末期内径(LVEDD),检测血清N末端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)水平、血红素加氧酶-1(HO-1)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)水平及外周血Nrf2、NF-κB的mRNA表达水平。结果干预4周后,观察组的NYHA分级、LVEDD、血清NT-proBNP、cTnI、TNF-α、IL-1β水平及外周血NF-κB的mRNA表达水平均低于对照组,6MWT、LVEF、血清HO-1水平及外周血Nrf2的mRNA表达水平均高于对照组,差异有统计学意义(P<0.05)。结论智能运动锻炼联合综合心脏康复能够显著改善AHF患者的心功能,相关的分子机制可能是通过抑制NF-κB和激活Nrf2的表达。Objective To investigate the effect of intelligent exercise combined with comprehensive cardiac rehabilitation on acute heart failure(AHF)and the mRNA expression levels of nuclear factor-E2related factor 2(Nrf2)/nuclear factor-κB(NF-κB).Methods A total of 102 patients with AHF were admitted to Beijing Chaoyang Hospital of Capital Medical University from January 2019 to May 2024.They were randomly divided into an observation group(51 cases receiving intelligent exercise combined with comprehensive cardiac rehabilitation on the basis of conventional treatment)and a control group(51 cases receiving conventional treatment).Before and after 4 weeks of intervention,cardiac function was evaluated using the New York Heart Association(NYHA)grade and the 6-minute walking test(6MWT).Echocardiography was used to measure left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD).Serum levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),heme oxygenase-1(HO-1),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and mRNA expression levels of Nrf2 and NF-κB in peripheral blood were also assessed.Results After 4 weeks of intervention,the NYHA grade,LVEDD,serum NT-proBNP,cTnI,TNF-α,and IL-1β levels,as well as peripheral blood NF-κB mRNA expression levels in the observation group were lower than those in the control group.Conversely,the 6MWT distance,LVEF,serum HO-1 levels,and peripheral blood Nrf2 mRNA expression levels were significantly higher in the observation group compared to the control group,with statistically significant differences(P<0.05).Conclusion Intelligent exercise combined with a comprehensive cardiac rehabilitation program can significantly improve cardiac function in patients with AHF.The underlying molecular mechanisms may include the inhibition of NF-κB and activation of Nrf2 expression.

关 键 词：急性心力衰竭 智能运动锻炼 综合心脏康复 炎症反应 氧化应激 

分 类 号：R54[医药卫生—心血管疾病]