应用通气阈控制男性肥胖型高血压患者的运动强度

目的:利用通气阈,观察男性肥胖高血压患者的适宜运动强度。方法:2004年从江西高校选取41例男性肥胖高血压者为观察对象。他们除了发现血压高、体质量指数超标外,无其他慢性病,平时不参加体育锻炼,受试者均知情同意。①运动处方的制定:以通气阈作为运动强度(相当于60%最大心率),让受试者进行为期1年的快走锻炼,运动时间为60min/次,隔日1次。每周三四次。②分别在实施运动处方前后按常规方法,各测定1次安静状态下的收缩压、舒张压、平均动脉压、心率和体成分、体质量、体质量指数、腰围、臀围、体脂、皮下脂肪面积、内脏脂肪面积。③要求受试者进行有氧运动,在达到通气阈时,记录下吸氧量、功率、心率、心率差、最高心率百分比、心率贮备百分比、主观运动强度、收缩压、平均动脉压、舒张压。结果:41例受试者全部进入结果分析。①实施运动处方前、后安静状态时各指标变化:体质量[(83.5±11.4),(78.1±7.4)kg]、体质量指数[(28.9±3.5),(27.2±2.3)kg/m2]、腰围[(95.4±8.3),(89.3±5.7)cm]、臀围[(100.6±5.9),(98.3±4.3)cm]、腰臀围比(0.95±0.05,0.91±0.04)、体脂百分比[(29.8±4.5)%,(26.6±4.3)%]、皮下脂肪面积[(147.8±35.1),(123.4±43.4)cm2];内脏脂肪面积[(109.8±57.2),(82.7±42.6)cm2]、内脏脂肪面积/皮下脂肪面积(0.80±0.51,0.72±0.39)、收缩压[(153.3±11.9),(127.0±12.1)mmHg]、舒张压[(97.0±12.6),(80.1±7.7)mmHg]和平均动脉压[(115.8±10.4),(95.7±8.7)mmHg]都有显著性改善(t=4.956～6.772,P<0.05或0.01)。②实施运动处方前、后,在通气阈时各指标变化:吸氧量[(13.5±2.1),(16.3±2.4)mL/(kg·min)]、功率[(75.1±16.5),(102.4±17.0)W],收缩压[(172.9±22.3),(149.3±15.9)mmHg]、舒张压[(100.1±16.4),(86.8±6.6)mmHg]及平均动脉压[(124.4±17.0),(107.7±7.0)mmHg]都有显著性改善(t=4.112～5.223,P<0.05);心率、心率差、最高心率百分比、心率贮备百分比以及主观强度感觉也都有改善。结论:对于男性肥胖高血压患者,可以采用通气阈确定其适宜运动强度,即运动强度是60%最高心率、30%心率贮备和主观运动强度12。     

乳酸阈强度训练对高血压患者的降压作用

高血压病的非药物治疗是康复医疗的重要内容。有氧训练作为非药物治疗的有效手段已被临床广泛采用。传统的训练强度采用心率作为强度控制的指标。但心率受影响的因素较多 ,特别是在采用各种血管活性药物之后。乳酸阈作为运动强度指标已经在冠心病康复中应用 ,但是目前无高血压病应用的报告。本研究旨在论证乳酸阈运动对高血压病患者的降压作用。研究对象 :2 8名 1- 2期高血压患者 ,其中 13名 ( 12男 ,1女 ,年龄 61.8± 5 .7岁 )参加有氧训练 ,另 15名 ( 13男 ,2女 ,年龄 62 .4± 6.4岁 )作为不运动对照组。两组患者均持续稳定服药半年以上 ,…     

胰岛素抵抗对老年男性肥胖高血压的影响

目的分析胰岛素抵抗与老年肥胖高血压的关系。方法用放射免疫法测定40例高血压和22例正常血压的老年男性患者血清胰岛素的含量。结果在高血压和肥胖分组中空腹血糖变化无显著性差异。非肥胖组高血压与正常血压者血清胰岛素的水平变化无显著性。肥胖组高血压者较正常血压者血清胰岛素含量平均升高2.7mIU/L(P<0.01)。高血压组中肥胖者较非肥胖者血清胰岛素水平平均升高4.7mIU/L(P<0.001)。胰岛素敏感指数在肥胖高血压组、肥胖非高血压组、非肥胖高血压组、非肥胖非高血压组中依次递减。结论老年肥胖高血压存在胰岛素抵抗,胰岛素与肥胖高血压有密切关系。     

一种康复评定的新指标—冠心病患者无氧阈的无损伤性测定

本文采用计算机辅助联机的Jaeger EOS自动分析系统对32名冠心病人和47名同龄健康人的无氧阈进行了测定分析,以探讨无氧阈指标在冠心病诊断和康复治疗中的应用价值。结果表明,冠心病人的无氧阈可采用气体代谢法进行无创性检测,它是一项反映心血管耐力和心贮备功能的敏感指标,并可应用于康复锻炼中,以选择安全、适宜的运动强度。本文方法和结果在制定运动处方时可资参考。     

肥胖高血压病人运动干预研究现状

从意义、方式和效果方面综述肥胖高血压病人运动干预的研究现状,指出运动干预能够从三级预防的各个阶段有效预防和治疗肥胖高血压,降低并发症及后遗症的发生率。目前肥胖高血压病人的运动干预具有多种形式,在干预时需全面评估病人的身体情况和所处环境,制定适宜的运动干预方案。同时,一定的质量保障措施是有效实施运动干预的关键,但提高肥胖高血压病人运动依从性的有效措施和监测运动强度的合理工具仍需进一步研究与探索。     

单纯性肥胖的运动处方

肥胖不仅在一定程度上影响人们的正常生活和心理健康，还与多种疾病有重要的发病学关系，本以运动处方形式推荐一些有氧运动及力量锻炼方法，旨在为不同程度的肥胖在减肥过程中提供较健康，科学的降脂减肥方法，以期达到经强身健体的目的。     

胰岛素抵抗对老年男性肥胖高血压的影响

目的：分析胰岛素抵抗与老年肥胖高血压的关系。方法：用放射免疫法测定40例高血压和22例正常血压的老年男性患者无显著性差异。非肥胖组高血压与正常血压者血清胰岛素的水平变化一。肥胖组高血压者较正常血压者血清胰岛素含量平均升高2．7mIU/L(P&;lt;0.01)。高血压组中肥胖者较非肥胖者血清胰岛素水平平均升高4．7mIU/L(P&;lt;0.001)。胰岛素敏感指数在肥胖高血压组、肥胖非高血压组、非肥胖高血压组、非肥胖非高血压组中依次递减。结论：老年肥胖高血压存在胰岛素抵抗，胰岛素与肥胖高血压有密切关系。     

高血压患者运动处方

目的：探讨高血压患运动处方对高血压患护理康复的作用。方法：将２４２例患随机分为康复组１２５例和对照组,康复组运用科学的运动种类。运动强度,运动持续时间和频度,进行康复运动训练,结果：康复组总有效率９７．６～,对照组８７．２％,康复组明显优于对照组,结论：高血压患运动处方高血压患的康复小重要作用。     

量化运动处方对肥胖2型糖尿病患者代谢指标的影响

目的：探讨量化运动处方对肥胖2型糖尿病患者代谢指标的影响。方法根据体重指数(BMI)将2型糖尿病患者分为正常体重组及肥胖组,均实施6个月的量化运动处方,分别观察3个月及6个月的体重指数(BMI)、空腹血糖(FBG)、餐后2h血糖、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)及空腹胰岛素水平。结果1.3个月后,肥胖组的BMI(下降值为2.4kg/m2)、餐后2h血糖(下降值为1.6mmol/L)、TG(下降值为0.6mmol/L)及空腹胰岛素(下降值为2.2mU/L)的下降幅度均明显高于正常体重组(P<0.05)。2.6个月后,肥胖组的BMI(下降值为4.6kg/m2)、FBG(下降值为2.7mmol/L)、餐后2h血糖(下降值为3.5mmol/L)、HbA1c(下降值为1.2%)、TG(下降值为0.9mmol/L)、空腹胰岛素(下降值为3.4mU/L)的下降均明显高于体重正常组(P<0.05)。结论肥胖的2型糖尿病患者能从运动处方带来更多代谢指标更大程度的改善,并且随着时间的延长,效果更明显。     

运动干预青少年单纯性肥胖效果的研究

目的：根据儿童青少年的生长发育特点和运动爱好特点,从运动干预角度以运动处方的形式对超重肥胖儿童青少年进行干预,以尝试找出更为合理且细化的运动处方,为学校、家庭及临床治疗提供客观的、可操作性的运动实施方案。方法：本次研究以北京十一学校初一年级12、13岁超重肥胖学生共108人为研究对象,其中实验组54人、对照组54人。测量并比较实验组受试者实验前后身体质量指数、肥胖度等反映肥胖状况的相关指标及与肥胖相关的生化指标的变化情况。结果与结论：3个月的运动干预使受试对象体重减轻、BMI值降低、身体脂肪含量减少,与国内外相近领域的其他研究报道相比是呈现相同性的,可以认定这些指标的变化与运动干预是有密切关系的。     

EMG signs of neuromuscular fatigue related to the ventilatory threshold during cycling exercise

We questioned whether electromyographic (EMG) signs of neuromuscular fatigue accompany the changes in respiratory variables measured at the ventilatory threshold (VTh) during exercise on a cycloergometer. This was based on the assumption that the activation of muscle afferents sensitive to accumulation of lactate and potassium is suspected to elicit both the EMG signs of fatigue and hyperventilation. In 39 subjects performing an incremental cycling, the EMG estimates of neuromuscular fatigue in vastus lateralis were a non-linear increase in root mean square (RMS), a decrease in median frequency (MF), a non-linear increase in low-frequency EMG energies (EL), and/or a decrease in high-frequency energies (EH). VTh was determined from a non-linear increase in VCO2 [VTh(VCO2 slope)] and an increased value of the respiratory equivalent for oxygen [VTh(VE/VO2)]. We measured a significant increase in venous blood concentration of lactate and potassium, and a significant pHv fall at VTh. One EMG estimate of fatigue was detected in 33/39 individuals and two EMG estimates in 17 subjects. Highly significant positive correlations were found between the oxygen uptakes corresponding to each EMG estimate and to each detection criterion of VTh. These observations suggest that the activation of muscle sensory pathways contribute to the mechanism of VTh.     

A new ventilatory threshold equation for aerobically trained men and women

The purposes of the present study were to (i) modify previously published ventilatory threshold (VT) equations using the constant error (CE) values for aerobically trained individuals from a recent study; (ii) cross‐validate the modified equations to determine their accuracy for estimating VT in aerobically trained individuals; (iii) derive a new non‐exercise based equation for estimating VT in aerobically trained individuals if the modified equations are found to be inaccurate; and (iv) cross‐validate the new VT equation using the Predicted REsidual Sum of Squares (PRESS) statistic and an independent sample of aerobically trained individuals. Two hundred and eight (n = 208) aerobically trained men and women (mean ± SD: age = 38·8 ± 10·4 year) performed a maximal incremental test on a cycle ergometer to determine the observed VT. The predicted VT values from seven published equations were compared with the observed VT by examining the CE, standard error of estimate, validity coefficient (r), and total error (TE). Cross‐validation of the modified equations resulted in high %TE values. Therefore, a new VT equation was derived. Cross‐validation of this equation on an independent sample of 72 subjects resulted in a low %TE value. The new model is recommended over previous models for estimating VT in aerobically trained individuals.     

肥胖对男青年血流动力学运动反应影响的实验研究

目的：探究肥胖对血流动力学运动反应的影响，为肥胖相关心血管疾病的运动监控提供理论支持。方法：体重正常和肥胖男青年各10名，连续采集运动前后系统血流动力学指标（BP、HR、DP、SI、CI）和指端血流动力学参数（K′、VDF、VCF、PCII、VCTI）进行分析。结果：肥胖青年男性运动前的SBP、rHR和rPCII明显高于体重正常者；运动后eSI和eCI明显低于体重正常者；运动后eK′和ePCII明显高于体重正常者。相关分析表明，Fat%与rSBP、rHR、eSI、eCI、eK′和ePCII密切相关；系统血流动力学指标和指端血流动力学指标间的偏相关分析表明，rPCII与rHR、eK′和eCI、ePCII和eCI密切相关。结论：肥胖会引发青年男性运动前后指端血流动力学改变。运动前后系统血流动力学和指端血流动力学指标间具有相关性，提示指端容积血流脉搏波参数有望成为运动心血管机能监测的新指标。     

无氧阈和高强度运动康复在慢性阻塞性肺疾病病人中的应用

目的:探究高强度运动对慢性阻塞性肺疾病(COPD)病人的康复效果。方法:采用随机抽样方法将40例稳定期中重度COPD病人等分为对照组和观察组。对照组以无氧阈为标准,观察组采用合理范围内的高强度运动,每周进行3次。本研究为期8周,研究结束后分别进行肺运动试验、非运动状态下心肺功能。结果:研究前后,两组病人的峰值功率、持续时间、无氧阈、峰值摄氧量等参数指数差异有统计学意义(P0.05)。结论:有氧运动对于COPD疾病在稳定时期的康复有着非常重要的作用,效果明显。     

Determination and possible application of the aerobic gas exchange threshold in aerobically untrained paraplegic subjects based on stimulated cycle ergometry

Purpose. To accurately characterise cardiopulmonary baseline performance in aerobically untrained paraplegic subjects by means of an incremental exercise test (IET) and to derive possible training recommendations based on these measurements.

Methods. Twelve motor complete paraplegic subjects with no previous experience in stimulated leg-cycling participated in the study. Exercise testing was performed on a recumbent FES-tricycle by means of a work rate and cadence controlled IET until maximal work rate was reached. Heart rate (HR) and respiratory parameters were recorded continuously.

Results. Peak oxygen uptake was 671 ± 192 mL min^?1 (mean ± standard deviation), peak HR 90 ± 12 beats min^?1, net peak power 8.4 ± 3.3 W and peak minute ventilation 23.6 ± 7.5 L min^?1. Aerobic gas exchange threshold (GET) was found to be 51% ± 10% of peak oxygen uptake and corresponded to 41% ± 13% of peak power.

Conclusions. A cadence and work rate controlled exercise test allows the determination of cardiopulmonary parameters during stimulated cycle ergometry even in aerobically untrained paraplegic subjects. The precise determination of GET allows an appropriate exercise intensity to be prescribed and thus provides a suitable method for exercise intensity calculation in the spinal cord injured population in the future.     

Effects of resistance or aerobic exercises on metabolic parameters in obese women who are not on a diet

This longitudinal, controlled clinical study was conducted to compare the effects of resistance exercise (RE) and aerobic exercise (AE) on body mass index (BMI), weight, fat mass (FM), serum lipid profile, and insulin resistance in obese women who cannot adhere to energy-restricted diets. A total of 60 obese women with severe eating disorders were evaluated. Patients were randomly divided into 3 groups: control group with no exercise (n=20), group 1 with AE (n=20), and group 2 with RE (n=20). Demographic and anthropometric measurements were taken. Serum lipid fractions and fasting (FGlc) and postprandial glucose insulin (PGlc) levels were measured. Insulin resistance was calculated with use of homeostasis model assessment (HOMA-IR). Total body FM was measured by bioelectric impedance analysis. After 12 wk of exercise, significant decreases in BMI, waist and weight measurements, and FGlc, PGlc, triglyceride, and total cholesterol levels were noted in each of the study groups. Reduced low-density lipoprotein cholesterol level and FM and HOMA-IR measurements were observed only in group 1 (with AE). This study indicated that AE and RE training induces improvement in body fat composition and has a favorable metabolic effect in obese women with severe eating disorders.     

糖尿病量化运动处方的安全性研究

目的评价糖尿病量化运动处方在2型糖尿病患者中应用的安全性。方法运动处方按运动量由小到大依次分为1-5级。选择80例2型糖尿病患者,每位患者均从运动量最小的处方1做起,然后依次递增至运动量最大的处方5,每级处方均连续3d。运动时间选择在晚餐后1h。每个运动处方的运动时间设为60min。运动前、运动结束即刻、运动结束后4、12h分别测定心率、血压、血氧饱和度,计算低血糖发生率,以评估量化运动处方的安全性。结果运动结束即刻、运动结束后4h及12h的心率、收缩压、舒张压及血氧饱和度均在正常值范围,运动结束即刻无低血糖发生,运动结束后4h及12h低血糖发生率为1.25％（1／80）-2.5％（2／80）。结论糖尿病量化运动处方是2型糖尿病患者安全的运动干预措施;1-5级糖尿病量化运动处方对2型糖尿病患者实施个体化运动干预提供了更多的选择。     

Influence of family history of hypertension on insulin sensitivity in lean and obese hypertensive subjects

We evaluated the influence of family history of hypertension on insulin sensitivity in lean and obese hypertensive subjects (H): 40 lean [body mass index (BMI)  25 kg m⁻²] H with normotensive parents (F−), 50 lean H with one or two parents hypertensive (F+), 30 obese HF− (BMI  30 kg m⁻²) and 35 obese HF+. The four groups were comparable in terms of age, sex and ambulatory blood pressure values. We evaluated glucose, insulin and C-peptide before and 30, 60, 90 and 120 min after an oral glucose load, insulin sensitivity index (ISI, fasting glucose/insulin ratio), fasting insulin/C-peptide ratio (I/Cp). Glucose, fasting and during test, and I/Cp were similar among the four groups; insulin and C-peptide, fasting and stimulated, were significantly higher and ISI lower in obese H than in lean H; at similar BMI, insulin and C-peptide were significantly higher in F+ than in F−. Insulin directly correlated with night-time blood pressure only in lean HF−. The correlation between insulin and BMI was significantly closer in F− than in F+. In conclusion, family history of hypertension appears to play a relevant role in insulin sensitivity in hypertensive subjects also in the presence of obesity.