等长收缩诱导的生理性缺血训练促进远隔缺血心肌侧支生成的研究

发布时间：2018-11-20 14:32

【摘要】：目的:观察冠心病患者外周肢体等长收缩诱导的生理性缺血训练是否可以促进远隔缺血心肌侧支循环形成,并探索其机制。方法:冠脉慢性完全闭塞患者21例随机分为对照组及等长握拳训练组。训练组患者进行3个月等长握拳诱导的生理性缺血训练,对照组不做任何训练活动。训练前后ELISA法测定血管内皮生长因子(VEGF)浓度、荧光激活流式细胞分离术测定内皮祖细胞(endothelial progenitor cells,EPCs)数量、心肌核素显像(single-photon emission computed tomography,SPECT)测定心肌缺血区血流灌注。结果:运动前,两组患者核素心肌显像静息节段总评分、外周血EPCs数量、VEGF浓度均无显著差异(P0.05)。经3个月等长握拳训练后,训练组EPCs数量、VEGF浓度均显著增加(P0.01);训练组SPECT观察缺血区域节段总评分有明显减少(P0.05)。而对照组训练前后无显著差异(P0.05)。两组患者训练后EPCs增量与VEGF增量,VEGF增量与静息节段总评分改善均呈中度相关(r=0.56,r=-0.60)。结论:冠心病患者等长握拳诱导的生理性缺血训练可通过VEGF及EPCs释放促进远隔缺血心肌侧支循环形成。
[Abstract]:Aim: to investigate whether physiologic ischemic training induced by peripheral isometric contraction in patients with coronary heart disease can promote collateral circulation formation and explore its mechanism. Methods: 21 patients with chronic complete coronary occlusion were randomly divided into control group and equal-length grip training group. The patients in the training group were trained with physiological ischemia induced by equal-length fist grip for 3 months, while the patients in the control group were not given any training activities. Before and after training, the concentration of vascular endothelial growth factor (VEGF) was measured by ELISA method, the number of endothelial progenitor cell (endothelial progenitor cells,EPCs) was determined by fluorescence activated flow cytometry (FFAC), and myocardial radionuclide imaging (single-photon emission computed tomography,) was performed. SPECT) was used to measure the blood flow in myocardial ischemia area. Results: before exercise, there was no significant difference in the total score of resting segment, the quantity of EPCs and the concentration of VEGF in peripheral blood of the two groups (P0.05). After 3 months of equal-length grip training, the number of EPCs and the concentration of VEGF in training group were significantly increased (P0.01), and the total score of SPECT in ischemic region was significantly decreased in training group (P0.05). There was no significant difference before and after training in the control group (P0.05). There was a moderate correlation between the increment of EPCs and VEGF, the increment of VEGF and the improvement of total score of resting segment after training in both groups (r = 0.56 ~ (-1) ~ (-0.60). Conclusion: physiologic ischemic training induced by equal-length fist grip in patients with coronary heart disease can promote the formation of collateral circulation in distant ischemic myocardium through the release of VEGF and EPCs.
【作者单位】：南京医科大学附属南京医院心脏科;南京医科大学第一附属医院康复医学科;
【基金】：国家自然科学基金资助项目(30570893) 南京市卫计委重点项目(ZKX16049)
【分类号】：R541.4

【相似文献】