有氧运动对高血压患者同型半胱氨酸和动态血压影响的研究

发布时间：2019-04-25 11:15

【摘要】：目的：研究高血压患者血HCY水平；研究中等强度有氧运动对H型高血压患者血HCY水平的影响；研究中等强度有氧运动对H型高血压患者动态血压的影响。方法：研究对象为50-69岁的中老年人,包括44名1级或2级高血压患者,22名血压正常者。用问卷调查法对研究对象进行初步筛选和运动前健康筛查；用实验法对研究对象进行各指标的测试和后期干预。采用Kolomogorov-Simirnov单样本检验数据分布是否正态。同一指标干预前后的比较采用配对T检验,同一指标两组之间的比较采用独立样本T检验；两个独立样本的非正态分布数据采用Mann-Whitney U非参数秩和检验；两个配对样本的非正态分布数据采用Wilcoxon符号秩检验。显著性水准分别为0.05和0.01。结果：(1)高血压患者血HCY平均水平比正常组高(14.81±5.44μmol/L vs 10.66 ±2.77μmol/L,P=0.001),且高血压患者中伴有高HCY的比例高达88.64%。(2)虽然安静时血压值没有显著性差异,但高血压组的24小时动态血压各指标均比正常组的高(P0.001)。(3)12周以后,实验组血HCY水平明显下降(17.94 ±3.69 μmol/L vs 12.87±2.79 μmol/L,P=0.001),而对照组没有发生显著性变化(16.54±3.52 p mol/L vs 14.81±2.23 μmol/L,P=0.117).(4)12周以后,实验组24小时血压变异性明显下降(SBP：12.20±1.75%vs 8.97±1.23%,P0.001；DBP：15.91±3.84%vs 11.37±1.45%,P=0.010)；而对照组24小时血压变异性没有发生显著性变化(SBP:12.43±1.03% vs 12.44± 1.65%,P=0.985:DBP:15.35±2.74%vs 17.31±3.40%,P=0.089)(5)12周以后,实验组24小时血压负荷值明显下降(SBP:32.16±13.57% vs 17.65± 11.44%,P=0.001:DBP:9.96±6.89%vs 1.59±1.90%,P=0.004)；而对照组24小时血压负荷值没有发生显著性变化(SBP:23.95±18.07%vs 26.36± 11.87%,P:0.411:DBP:12.40±7.34%vs 13.94±6.97%,P=0.578).(6)12周以后,实验组晨峰血压明显下降(SBP:29.55±9.38mmHg vs 14.48± 5.88mmHg,P=0.001:DBP:19.67±11.47mmHg vs 11.39±601mmHg,P=0.007)；而对照组晨峰血压没有发生显著性变化(SBP:30.58±12.05mmHg vs 27.21± 10.35mmHg,P=0.235:DBP:26.83±11.08mmHg vs 26.04±10.21mmHg,P=0.692).结论：(1)高血压患者的血HCY水平比血压正常者高,且伴有同型半胱氨酸水平升高的比例高达88.64%。(2)12周中等强度有氧运动能够有效降低H型高血压患者的血HCY水平。(3)12周中等强度有氧运动能够有效降低服用降压药的H型高血压患者清晨6-8点血压值,降低晨峰血压,比单一的药物治疗效果更好。(4)12周中等强度有氧运动能够降低服用降压药的H型高血压患者血压波动性,减少血压异常升高的频率,比单一的药物治疗效果更好。
[Abstract]:Aim: to study the effect of moderate intensity aerobic exercise on blood HCY level in patients with type H hypertension, and to study the effect of moderate intensity aerobic exercise on ambulatory blood pressure in patients with type H hypertension, and to study the effect of moderate intensity aerobic exercise on blood HCY level in patients with type H hypertension. Methods: forty-four patients with grade 1 or 2 hypertension and 22 patients with normal blood pressure were enrolled in the study. Primary screening and pre-exercise health screening of the subjects were carried out by questionnaire survey, and test and post-intervention of the subjects were carried out by the experimental method. Kolomogorov-Simirnov single sample was used to check whether the data distribution was normal or not. Paired T test was used for comparison before and after intervention of the same index, independent sample T test was used for comparison of the same index and non-normal distribution data for two independent samples, Mann-Whitney U non-parametric rank sum test was used for comparison between the same index group and the other two groups. The non-normal distribution data of two paired samples were tested by Wilcoxon signed rank test. The significance levels are 0.05 and 0.01 respectively. Results: (1) the mean level of serum HCY in patients with hypertension was higher than that in the normal group (14.81 卤5.44 渭 mol / L vs 10.66 卤2.77 渭 mol / L, P < 0.001). The percentage of hypertension patients with high HCY was 88.64%. (2) although there was no significant difference in blood pressure at rest, the indexes of 24-hour ambulatory blood pressure in hypertension group were higher than those in normal group (P0.001). (3) 12 weeks later. The level of serum HCY decreased significantly in the experimental group (17.94 卤3.69 渭 mol/L vs 12.87 卤2.79 渭 mol/L,P=0.001), but there was no significant change in the control group (16.54 卤3.52 p mol/L vs 14.81 卤2.23 渭 mol/L,). After 12 weeks, the blood pressure variability in the experimental group decreased significantly (SBP: 12.201.75% vs 8.97 卤1.23%, P0.001). DBP:15.91 卤3.84%vs 11.37 卤1.45%, P0. 010); There was no significant change in 24-hour blood pressure variability in control group (SBP:12.43 卤1.03% vs 12.44 卤1.65%, P = 0.985 DBP: 15.35 卤2.74% vs 17.31 卤3.40%, P = 0.089) (5) 12 weeks later. The 24-hour BP load was significantly decreased in the experimental group (SBP:32.16 卤13.57% vs 17.65 卤11.44%, P < 0.001 卤6.89% vs 1.90%, P < 0.004). There was no significant change in the 24-hour blood pressure load in the control group (SBP: 23.95 卤18.07% vs 26.36 卤11.87%, P = 0.411 DBP: 12.40 卤7.34% vs 13.94 卤6.97%, P = 0.578). (6) after 12 weeks. In the experimental group, the morning peak blood pressure was significantly decreased (SBP: 29.55 卤9.38 mmHg vs 14.48 卤5.88 mm Hg, P < 0.001 DBP: 19.67 卤11.47 mmHg vs 11.39 卤601 mmHg,P=0.007). There was no significant change in the morning peak blood pressure in the control group (SBP: 30.58 卤12.05 mmHg vs 27.21 卤10.35 mm Hg, P = 0.235 DBP: 26.83 卤11.08 mmHg vs 26.04 卤10.21 mmHg,P=0.692). Conclusion: (1) the level of blood HCY in patients with hypertension is higher than that in patients with normal blood pressure. The percentage of patients with elevated homocysteine level was 88.64%. (2) 12-week moderate aerobic exercise could effectively reduce the level of blood HCY in patients with type H hypertension. (3) 12-week moderate-intensity aerobic exercise could effectively reduce the level of blood HBP in patients with type H hypertension. Effectively reduce blood pressure at 6: 8 a. M. in patients with type H hypertension who take antihypertensive drugs, Lowering morning peak blood pressure is better than single drug therapy. (4) 12-week moderate aerobic exercise can reduce blood pressure fluctuation and reduce the frequency of abnormal elevation of blood pressure in H-type hypertension patients who take antihypertensive drugs. It works better than a single drug.
【学位授予单位】：北京体育大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1

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