【摘要】：目的：研究高血壓患者血HCY水平；研究中等強(qiáng)度有氧運(yùn)動(dòng)對(duì)H型高血壓患者血HCY水平的影響；研究中等強(qiáng)度有氧運(yùn)動(dòng)對(duì)H型高血壓患者動(dòng)態(tài)血壓的影響。方法：研究對(duì)象為50-69歲的中老年人,包括44名1級(jí)或2級(jí)高血壓患者,22名血壓正常者。用問卷調(diào)查法對(duì)研究對(duì)象進(jìn)行初步篩選和運(yùn)動(dòng)前健康篩查；用實(shí)驗(yàn)法對(duì)研究對(duì)象進(jìn)行各指標(biāo)的測(cè)試和后期干預(yù)。采用Kolomogorov-Simirnov單樣本檢驗(yàn)數(shù)據(jù)分布是否正態(tài)。同一指標(biāo)干預(yù)前后的比較采用配對(duì)T檢驗(yàn),同一指標(biāo)兩組之間的比較采用獨(dú)立樣本T檢驗(yàn)；兩個(gè)獨(dú)立樣本的非正態(tài)分布數(shù)據(jù)采用Mann-Whitney U非參數(shù)秩和檢驗(yàn)；兩個(gè)配對(duì)樣本的非正態(tài)分布數(shù)據(jù)采用Wilcoxon符號(hào)秩檢驗(yàn)。顯著性水準(zhǔn)分別為0.05和0.01。結(jié)果：(1)高血壓患者血HCY平均水平比正常組高(14.81±5.44μmol/L vs 10.66 ±2.77μmol/L,P=0.001),且高血壓患者中伴有高HCY的比例高達(dá)88.64%。(2)雖然安靜時(shí)血壓值沒有顯著性差異,但高血壓組的24小時(shí)動(dòng)態(tài)血壓各指標(biāo)均比正常組的高(P0.001)。(3)12周以后,實(shí)驗(yàn)組血HCY水平明顯下降(17.94 ±3.69 μmol/L vs 12.87±2.79 μmol/L,P=0.001),而對(duì)照組沒有發(fā)生顯著性變化(16.54±3.52 p mol/L vs 14.81±2.23 μmol/L,P=0.117).(4)12周以后,實(shí)驗(yàn)組24小時(shí)血壓變異性明顯下降(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)；而對(duì)照組24小時(shí)血壓變異性沒有發(fā)生顯著性變化(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,實(shí)驗(yàn)組24小時(shí)血壓負(fù)荷值明顯下降(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)；而對(duì)照組24小時(shí)血壓負(fù)荷值沒有發(fā)生顯著性變化(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,實(shí)驗(yàn)組晨峰血壓明顯下降(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)；而對(duì)照組晨峰血壓沒有發(fā)生顯著性變化(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).結(jié)論：(1)高血壓患者的血HCY水平比血壓正常者高,且伴有同型半胱氨酸水平升高的比例高達(dá)88.64%。(2)12周中等強(qiáng)度有氧運(yùn)動(dòng)能夠有效降低H型高血壓患者的血HCY水平。(3)12周中等強(qiáng)度有氧運(yùn)動(dòng)能夠有效降低服用降壓藥的H型高血壓患者清晨6-8點(diǎn)血壓值,降低晨峰血壓,比單一的藥物治療效果更好。(4)12周中等強(qiáng)度有氧運(yùn)動(dòng)能夠降低服用降壓藥的H型高血壓患者血壓波動(dòng)性,減少血壓異常升高的頻率,比單一的藥物治療效果更好。
[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 鹵5.44 渭 mol / L vs 10.66 鹵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 鹵3.69 渭 mol/L vs 12.87 鹵2.79 渭 mol/L,P=0.001), but there was no significant change in the control group (16.54 鹵3.52 p mol/L vs 14.81 鹵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 鹵1.23%, P0.001). DBP:15.91 鹵3.84%vs 11.37 鹵1.45%, P0. 010); There was no significant change in 24-hour blood pressure variability in control group (SBP:12.43 鹵1.03% vs 12.44 鹵1.65%, P = 0.985 DBP: 15.35 鹵2.74% vs 17.31 鹵3.40%, P = 0.089) (5) 12 weeks later. The 24-hour BP load was significantly decreased in the experimental group (SBP:32.16 鹵13.57% vs 17.65 鹵11.44%, P < 0.001 鹵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 鹵18.07% vs 26.36 鹵11.87%, P = 0.411 DBP: 12.40 鹵7.34% vs 13.94 鹵6.97%, P = 0.578). (6) after 12 weeks. In the experimental group, the morning peak blood pressure was significantly decreased (SBP: 29.55 鹵9.38 mmHg vs 14.48 鹵5.88 mm Hg, P < 0.001 DBP: 19.67 鹵11.47 mmHg vs 11.39 鹵601 mmHg,P=0.007). There was no significant change in the morning peak blood pressure in the control group (SBP: 30.58 鹵12.05 mmHg vs 27.21 鹵10.35 mm Hg, P = 0.235 DBP: 26.83 鹵11.08 mmHg vs 26.04 鹵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.
【學(xué)位授予單位】：北京體育大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R544.1

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