不同有氧运动模式对原发性高血压患者心肌肥厚、自主神经功能及运动耐力的影响

薛同能; 雍辉; 陈雨

doi:10.12125/j.chj.202112026

不同有氧运动模式对原发性高血压患者心肌肥厚、自主神经功能及运动耐力的影响

Comparison of effects of different aerobic exercise modes on myocardial hypertrophy, autonomic nervous functions and exercise tolerance in patients with primary hypertension

摘要

摘要:
目的研究不同有氧运动模式对原发性高血压患者心肌肥厚、自主神经功能及运动耐力的影响。
方法选取2018年6月～2020年3月在南京医科大学附属淮安第一医院就诊的原发性高血压患者123例，随机分为A、B、C组。A组为安静对照组，不进行运动训练；B组进行中低强度持续有氧运动训练；C组进行高强度间歇有氧运动训练，运动训练持续12周。对比三组训练前后血压、体质量、左心室质量指数（LVMI）、左心室舒张末期内径（LVDd）、左心室后壁厚度（LVPWT）、室间隔厚度（IVST）水平变化，自主神经功能及运动耐力变化。
结果与训练前比较，三组患者训练4、8与12周后收缩压与舒张压均降低（均P<0.01）；与训练4周后本组比较，训练8与12周后收缩压与舒张压均降低（均P<0.01）。与训练8周后本组比较，训练12周后收缩压与舒张压均降低（均P<0.01）。与A组训练后同时段比较，B组、C组收缩压与舒张压均降低（均P<0.01）；与B组训练后同时段比较，C组收缩压与舒张压均降低（均P<0.01）；训练后与训练前比较，A组LVMI与LVDd降低（均P<0.01），LVPWT与IVST降低（均P<0.05），B组与C组体质量、LVMI、LVDd、LVPWT与IVST均降低（均P<0.01）；与训练后A组比较，B组体质量、LVMI、LVDd、LVPWT、IVST均降低（均P<0.05），C组体质量、LVMI、LVDd、LVPWT、IVST均降低（均P<0.01）；与训练后B组比较，C组体质量、LVMI、LVDd、LVPWT、IVST均降低（均P<0.01）。训练后与训练前比较，三组VO₂与METs水平均升高（均P<0.01）；训练后与A组比较，B组VO₂与METs水平均升高（均P<0.05），C组VO₂与METs水平均升高（均P<0.01）；训练后与B组比较，C组VO₂与METs水平均升高（均P<0.01）。
结论高强度间歇有氧运动、中低强度持续有氧运动均能有效降低原发性高血压患者的血压，减轻体质量，改善患者心肌肥厚和自主神经功能，提高运动耐力，且高强度间歇有氧运动的效果更佳。

Abstract:
AIM To study the effects of different aerobic exercise modes on myocardial hypertrophy, autonomic nerve function and exercise endurance in patients with essential hypertension.
METHODS 123 patients with essential hypertension treated in Huai'an First Hospital Affiliated to Nanjing Medical University from June 2018 to March 2020 were randomly divided into groups a, B and C. Group A was a quiet control group without exercise training; Group B received low and medium intensity continuous aerobic exercise training; Group C received high-intensity intermittent aerobic exercise training, which lasted for 12 weeks. The changes of blood pressure, body mass, left ventricular mass index (LVMI), left ventricular end diastolic diameter (LVDD), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (ivst), autonomic nerve function and exercise endurance were compared before and after training.
RESULTS compared with before training, the systolic and diastolic blood pressure of the three groups decreased after 4, 8 and 12 weeks of training (all P<0.01); Compared with the group after 4 weeks of training, the systolic and diastolic blood pressure decreased after 8 and 12 weeks of training (all P<0.01). Compared with the group after 8 weeks of training, the systolic and diastolic blood pressure decreased after 12 weeks of training (all P<0.01). Compared with group A at the same time after training, systolic and diastolic blood pressure in group B and group C decreased (all P<0.01); Compared with the same period after training in group B, the systolic and diastolic blood pressure in group C decreased (all P<0.01); After training, compared with before training, LVMI and LVDD decreased in group A (all P<0.01), LVPWT and ivst decreased (all P<0.05), and body mass, LVMI, LVDD, LVPWT and ivst decreased in group B and C (all P<0.01); Compared with group A after training, the body mass, LVMI, LVDD, LVPWT and ivst of group B decreased (all P<0.05), and the body mass, LVMI, LVDD, LVPWT and ivst of group C decreased (all P<0.01); Compared with group B after training, the body mass, LVMI, LVDD, LVPWT and ivst in group C decreased (all P<0.01). After training, compared with before training, the levels of VO₂ and MetS in the three groups increased (all P<0.01); After training, compared with group A, the levels of VO₂ and MetS in group B increased (all P<0.05), and the levels of VO₂ and MetS in group C increased (all P<0.01); After training, compared with group B, the levels of VO₂ and MetS in group C increased (all P<0.01).
CONCLUSION High intensity intermittent aerobic exercise and medium and low intensity continuous aerobic exercise effectively reduce blood pressure, reduce body weight, improve myocardial hypertrophy and autonomic nerve function, and improve exercise endurance, and the effect of high-intensity intermittent aerobic exercise is better.

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