抗阻运动对改善2型糖尿病患者心血管风险的效果研究

发布时间：2018-02-27 00:25

本文关键词： 2型糖尿病抗阻运动有氧运动心血管风险 Framingham危险评分冠心病缺血性心血管病　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:在糖尿病饮食的基础上,对2型糖尿病患者实施抗阻和有氧运动训练,比较抗阻运动和有氧运动改善患者的冠心病(CHD)10年风险、10年缺血性心血管病(ICVD)危险效果的差异;以及评价抗阻运动对2型糖尿病患者血糖、血脂、血浆同型半胱氨酸(Hcy)、血清胱抑素C(CysC)等代谢指标的影响。方法:对80例2型糖尿病患者进行糖尿病饮食宣教,随后将其随机分成抗阻运动组和有氧运动组,每组各40例,抗阻运动组和有氧运动组每周各运动3次,每次50min,总计6个月,强度达到中等强度。结果:参与研究的患者共80例,完成研究69人,剔除4名不合格患者,最终获得65例患者数据,其中抗阻运动组32例,有氧运动组33例。干预前,两组在基线资料方面具有可比性(P0.05)。6个月运动干预后,抗阻组与有氧组组间比较,腰围、肌肉量、Hcy前后差值d(运动后数值减去运动前数值)的变化有统计学意义(P0.05)。两组组内比较,抗阻运动组,肌肉量(P0.001)、HDL-C 水平(P=0.021),HbA1c(P=0.026)、空腹胰岛素水平(P=0.026)、Hcy 浓度(P0.001),Framingham 危险评分(P=0.029)和 CHD 10 年风险(P=0.017)有统计学意义;有氧运动组,在腰围(P=0.001)、腰臀比(P=0.032),空腹血糖水平(P=0.006)、HbA1c(P0.001)、HDL-C(=0.026)、TC(P=0.020)和 Cys C 浓度(P=0.021)、Framingham 危险评分(P 0.003)和 CHD 10 年风险(P=0.002)有统计学意义。结论:1.组间比较发现,与有氧运动相比,抗阻组在提高患者肌肉量和Hcy浓度方面优于有氧组;与抗阻组相比,有氧组在减少腰围方面优于抗阻组。2.6个月后,两组虽然在改善ICVD综合危险评分和10年ICVD危险方面无统计学差异,但是都有下降趋势,且抗阻组优于有氧组。3.组内比较发现,抗阻运动和有氧运动对患者餐后2h血糖、胰岛素抵抗、ICVD综合危险评分和1 0年ICVD危险的作用效果均无统计学意义,但均有改善趋势。4.6个月的抗阻运动和有氧运动均能有效提高HDL-C水平,降低HbA1c,改善Framingham危险评分和CHD 10年风险。5.6个月的抗阻运动可有效地提高肌肉量、降低空腹胰岛素水平和Hcy浓度。6个月的有氧运动可有效降低腰围、腰臀比,空腹血糖水平、TC和CysC浓度。6.抗阻运动在改善HbA1c、HDL-C和CHD10年风险方面,与有氧运动作用相似;但抗阻运动在肌肉量增长,空腹胰岛素水平和Hcy浓度降低方面具有明显优势,因而对于老年人,除了能增加肌肉量,还能降低Hcy浓度,减少动脉粥样硬化疾病与脑卒中风险,若没有明显的运动禁忌症,抗阻运动是值得推荐的运动方式。
[Abstract]:Objective: on the basis of diabetic diet, the patients with type 2 diabetes mellitus were trained with resistance and aerobic exercise to compare the effects of resistance exercise and aerobic exercise on improving the risk of coronary heart disease (CHD) for 10 years and the risk of ischemic cardiovascular disease (ICVD) in 10 years. To evaluate the effects of resistance exercise on blood glucose, blood lipid, plasma homocysteine cystatin and serum cystatin CysC in patients with type 2 diabetes mellitus. Methods: 80 patients with type 2 diabetes mellitus were given diet education. Then they were randomly divided into resistance exercise group (n = 40) and aerobic exercise group (n = 40). The resistance exercise group (n = 40) and aerobic exercise group (n = 40) were given 50 mins of exercise three times a week for a total of 6 months. Results: 80 patients participated in the study. Data of 65 patients were obtained, including 32 cases of resistance exercise group and 33 cases of aerobic exercise group. Before intervention, the baseline data of the two groups were comparable (P 0.05). After 6 months of exercise intervention, there was no significant difference between the two groups in terms of baseline data. There was significant difference in waist circumference, muscle volume and Hcy before and after exercise between resistance group and aerobic group (P 0.05). The levels of HDL-C, fasting insulin level and CHD 10-year risk factor P0. 029 and P0. 017 in aerobic exercise group were significantly higher than those in P0. 021, P0. 026, P0. 026, P0. 001 and P0. 029). There were statistical significance in the waist circumference (P = 0.001), waist / hip ratio (P = 0.032), fasting blood glucose level (P = 0.006), HbA1cn (P 0.001), HDL-C (0.026) and Cys C (P ~ (0.021) Cys risk score P 0.003) and CHD (n = 10), P 0.002). Conclusion: compared with exercise, there is a significant difference between the two groups. The resistance group was superior to the aerobic group in improving the muscle mass and Hcy concentration of the patients, and the aerobic group was superior to the resistance group in reducing waist circumference compared with the resistance group. 2.6 months later, Although there was no significant difference between the two groups in improving the comprehensive risk score of ICVD and the risk of ICVD in 10 years, there was a downward trend in both groups, and the resistance group was better than the aerobic group .3.The results showed that resistance exercise and aerobic exercise had significant effects on 2 h postprandial blood glucose. The comprehensive risk score of insulin resistance and the effect of 10 years of ICVD risk had no statistical significance, but there was a trend of improvement. 4.6 months of resistance exercise and aerobic exercise could effectively increase the level of HDL-C. Reducing HbA1c, improving Framingham risk score and CHD 10 years risk. 5.6 months of resistance exercise can effectively increase muscle mass, reduce fasting insulin level and Hcy concentration. 6 months aerobic exercise can effectively reduce waist circumference, waist to hip ratio. Fasting blood glucose level TC and CysC concentration. 6. Resistance exercise is similar to aerobic exercise in improving HDL-C and CHD10 annual risk, but resistance exercise has obvious advantages in increasing muscle mass, decreasing fasting insulin level and decreasing Hcy concentration. Therefore, for the elderly, in addition to increase muscle mass, but also reduce the concentration of Hcy, reduce the risk of atherosclerosis and stroke, if there is no obvious exercise contraindication, resistance to exercise is a recommended exercise mode.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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