运动疗法控制老年代谢综合征危险因素的效果分析

目的：观察运动疗法控制老年代谢综合征危险因素的效果。方法：选择具有2种或2种以上老年代谢综合征危险因素者62例,随机分为观察组32例和对照组30例,对照组采用常规药物治疗。观察组在常规治疗基础上增加中等量的有氧运动,对治疗前后其代谢综合征危险因素进行动态观察。结果：治疗前两组患者代谢综合征危险因素无显著差异（P〉0．05）;治疗后观察组空腹血糖、血压、胰岛素抵抗与对照组比较,差异显著（P〈0．05）。结论：运动疗法具有控制血糖、调整血压、调整血脂紊乱、改善胰岛素抵抗等功效,对抑制老年代谢综合征危险因素的发生有积极作用。     

不同强度健步走锻炼对老年男子身体成分和血脂影响的比较

目的:探讨老年人进行健身锻炼的适宜运动强度,为老年人群科学健身提供理论指导。方法:以健康检查和调查问卷方式筛选出61～65岁健康老年男性32名,随机分为3个运动强度组,分别以心脏功能能力(F.C.)的30%～45%、46%～60%、61%～75%的运动强度进行8周健步走锻炼,每周锻炼3次,每次维持靶心率30分钟。运动中以心率、步行速度和主观感觉疲劳等级(RPE)相结合控制运动强度。分别测定锻炼前后受试者的身体成分和血脂水平。主要结果和结论:随着运动强度的增加,运动降低血脂的效果趋于减弱,中、小强度有氧运动(30%～60%F.C.)降低血脂的效果好于大强度有氧运动(61%～75%F.C.)。经过8周的健步走锻炼,3个组的身体脂肪总量、体脂%、体重和BMI均值均有所下降,但无统计学意义,提示可能是由实验期较短所致。建议:30%～60%F.C.的强度可作为61～65岁老年男性降血脂锻炼的适宜运动强度。     

评估代谢综合征的临床意义

随着社会经济的发展和人民生活水平的提高,与人类主要饮食成分有关的多代谢异常及其相关的血管损伤性疾病患病率及死亡率均有所增加这种情况在发展中国家尤为明显。我国正是代谢病高发的发展中国家,相关的心、脑血管病变发生和死亡的危险均在增加,所以及早控制代谢异常对减少心、脑血管病变发病率、降低死亡率意义重大。1代谢综合征(metabolic syndrome,MS)的流行趋势及控制现状流行病学资料显示,无论是在发达国家还是发展中国家,目前公认的代谢综合征四组病症的人群累及率均很高,尤其老年人群达90%以上[1]老年人MS检出率高于中青年,如老…     

老年男性患者超重/肥胖特点及与代谢综合征的关系

 目的 研究老年男性住院患者超重/肥胖的临床特点及代谢综合征的关系,为武警部队老年患者疾病的防治提供依据.方法 以2003～2005年在武警总医院住院的武警部队老年男性住院患者的病例为研究对象,对其超重/肥胖临床特点及代谢综合征的关系进行分析.结果 (1)武警部队老年男性住院患者存在较高的超重/肥胖患病比例,随着年龄增长,超重/肥胖患病比例有增加趋势,但在不同年龄组呈现不同特点.(2)按体重指数(BMI)分层,不同BMI组高血压、血糖升高、血脂紊乱及代谢综合征的检出率不同(P＜0.05),随着BMI的增加,代谢综合征及各组分的检出率逐渐升高(P＜0.05).(3)与正常BMI组比较,超重/肥胖组老年男性患者的收缩压、舒张压、空腹及餐后2小时血糖、甘油三脂明显升高,高密度脂蛋白明显降低(P＜0.05).(4)与正常BMI组比较,超重/肥胖组老年患者的颈动脉硬化、高血压、冠心病、脂肪肝、血糖及血脂紊乱的患病比例较明显增加(P＜0.05).(5)非条件Logistic回归分析显示,高血压及甘油三脂升高与武警老年男性老年超重/肥胖呈正相关.结论 武警部队老年患者存在较严重的超重/肥胖状况,是导致老年患者代谢综合征及相关疾病的重要危险因素.因此,防治肥胖对预防老年人的代谢综合征发生具有重要意义.     

老年人进行推拿功法易筋经不同呼吸次数锻炼的运动强度研究

目的:对老年人进行推拿功法易筋经不同呼吸次数锻炼的运动强度进行量化。方法:90名老年人随机分成三组,培训2个月后分别以推拿功法易筋经锻炼中定势站桩时长呼吸7次、9次和11次进行锻炼1个月,测试并比较各组锻炼前后及组间心率以及自觉运动强度分级(rate of perceived exertion,RPE),分析各组锻炼后目标心率(target heart rate,THR)。结果:①三组锻炼后心率均增加,组内前后差异显著(P<0.05)。②锻炼后,站桩定势呼吸7次组平均心率低于呼吸9次组和11次组,有统计学意义(P<0.05),呼吸9次组和11次组心率比较无显著性差异(P>0.05)。③呼吸7次组锻炼后达到目标心率的人数少于呼吸9次组和11次组,有统计学意义(P<0.05),呼吸9次组和11次组比较无显著性差异(P>0.05)。④自觉运动强度分级比较,随着站桩定势呼吸次数的增加,强度分级也逐步增加,三组之间有显著性差异(P<0.05)。自觉运动强度等级12～13级人数构成比,呼吸9次组多于呼吸7次组和11次组,有显著性差异(P<0.05)。结论:三种锻炼方式的运动强度不同,其差异由定势站桩时长(呼吸7次、9次、11次)不同导致,其中每一站桩定势动作持续呼吸9次、锻炼时间约18分钟,可以达到一定的锻炼强度。     

老年功能性消化不良的营养评估及护理干预对策

老年人随着年龄的不断增长,生理机能逐渐退化,使得营养不良发病率增高[1].功能性消化不良(functional dyspepsia,FD)是指存在被认为源自胃十二指肠区域的症状,且无任何可以解释这些症状的器质性、系统性或代谢性疾病[2],这些症状可能导致老年人饮食状况不佳,增加发生营养不良的危险.本研究应用微型营养评定法(mini nutritional assessment,MNA)评估老年FD患者的营养状况,并探讨可行的护理干预对策,以达到改善老年FD患者营养状况的目的.     

核心力量练习对男性老年人下肢肌力、平衡能力与跌倒风险的干预效果

目的:探讨核心力量练习对老年人跌倒风险因素的干预效果。方法:选取60~76岁男性老年人,随机分为核心力量练习组和对照组,每组9人。核心力量练习组采用以自身体重为负荷的支撑练习和利用不稳定器械进行的组合练习,对照组进行健身路径器械练习,每次1小时,每周4天,每天1次,持续12周。12周锻炼前后测试受试者下肢肌力、动态平衡能力及跌倒指数等指标变化。结果:(1)核心力量练习组受试者锻炼前、后30 s站起次数分别为11.67±1.35、12.50±1.77(P<0.01);动态平衡得分分别为76.73±4.30、79.80±2.66(P<0.05);跌倒指数分别为45.89±6.17、39.44±8.62(P<0.01)。(2)对照组受试者锻炼前后30s站起次数分别为12.78±1.23、14.50±1.62(P<0.01),其他指标未见显著变化。结论:12周核心力量练习能够显著增强男性老年人下肢肌肉力量和动态平衡能力,对降低老年人跌倒风险具有显著效果。12周健身路径练习可增强老年人下肢肌肉力量,但对平衡能力改善和跌倒风险无明显干预效果。     

健身老年人孤独感调查分析

目的:了解健身老年人孤独感现状及其特征。方法:采用随机抽样法在南京城区抽取1066名实足年龄60岁以上的老年人为研究对象。采用自编调查问卷和UCLA孤独问卷入户调查。结果:与非健身老年人相比,健身老年人孤独感得分较低,其中无孤独感或存在轻度孤独感的老年人居多;在婚状态的健身老年人孤独感评分显著低于其它婚姻状态的健身老年人;每周锻炼≥6次、每次持续≥60分钟对抑制或降低孤独感效果显著。结论:健身老年人孤独感水平较低,婚姻状态是健身老年人产生孤独感的危险因素,健身频率和每次健身持续时间是抑制或降低孤独感的保护因素。     

老年人长跑锻炼对甲襞微循环的影响

对120例健康老年长跑队队员与120例不参加长跑的健康老年人进行了甲襞微循环对照观察,结果发现:老年长跑锻炼组甲襞微循环形态积分、流态积分、总积分均显著低于老年长跑锻炼组(P<0.01),而袢周积分两组无显著差异(P>0.05)。坚持长跑锻炼能改善老年人的甲襞微循环。     

热带岛屿工作人员功能性消化不良发病及疗效分析

目的 调查在热带岛屿工作期间人员功能性消化不良(functional dyspepsia,FD)的发病情况并分析影响因素,相应给予干预治疗后观察疗效。方法 采用整群抽样方法,按照功能性胃肠疾病罗马Ⅲ分类及诊断标准,调查驻岛人员FD的发病率及影响因素;将入组人员随机分为治疗组和对照组,对照组给予吗丁啉、多酶片对症治疗,治疗组在对照组基础上给予合理饮食、养成良好的作息及生活习惯等健康教育。3个月后进行回归性调查,了解治疗效果。结果 热带岛屿工作人员FD发病率为12.77%,2个亚型发病率(上腹痛综合征6.79%,餐后不适综合征6.58%)差异比较无统计学意义(P>0.05);值班频度、高温高湿工作环境、吸烟、饮酒是FD发病的相关影响因素(P<0.05)。干预治疗后,治疗组有效率(66.67%)明显高于对照组(34.78%)（χ2=5.146,P=0.021）。结论 FD发病与工作紧张度、特殊工作环境及一些不良生活习惯呈正相关,通过系统的健康教育同时配合药物治疗可有效地控制FD发病。     

Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study

PURPOSE: To determine the efficacy of exercise training in treating the metabolic syndrome. METHODS: The sample included 621 black and white participants from the HERITAGE Family Study, identified as sedentary and apparently healthy (no chronic disease or injury). The metabolic syndrome was defined as having three or more risk factors according to the guidelines of the National Cholesterol Education Program, including elevated waist circumference, blood pressure, triglycerides, blood glucose, and low HDL cholesterol. The presence of the metabolic syndrome and component risk factors were determined before and after 20 wk of supervised aerobic exercise training. RESULTS: The prevalence of the metabolic syndrome was 16.9% in this sample (105/621) of apparently healthy participants. Of the 105 participants with the metabolic syndrome at baseline, 30.5% (32 participants) were no longer classified as having the metabolic syndrome after the exercise training. Among the 32 participants who improved their metabolic profile, 43% decreased triglycerides, 16% improved HDL cholesterol, 38% decreased blood pressure, 9% improved fasting plasma glucose, and 28% decreased their waist circumference. There were no sex or race differences in the efficacy of exercise in treating the metabolic syndrome: 32.7% of men, 28.0% of women, 29.7% of black, and 30.9% of white participants with the metabolic syndrome were no longer classified as having the syndrome after training. CONCLUSION: Aerobic exercise training in patients with the metabolic syndrome can be useful as a treatment strategy and provides support for a role for physical activity in the prevention of chronic disease.     

Metabolic clustering, physical activity and fitness in nonsmoking, middle-aged men

PURPOSE: The relationship of both physical activity and predicted maximum oxygen consumption (VO2max) with the clustering of metabolic risk factors associated with the metabolic syndrome (MS) was examined within 711 employed middle-aged (46.9 +/- 7.8 yr) men. METHODS: Metabolic markers included fasting glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure, and BMI, defined by highest risk quintiles or clinically relevant risk thresholds. RESULTS: The prevalence and age-adjusted odds ratios of all MS clusters were inversely graded across both higher physical activity index (PAI) and cardiorespiratory fitness (CRF) categories. The age-adjusted odds ratio for the clustering of clinically relevant metabolic markers was 0.60 (95% CI 0.22-1.22) for subjects in the occasional/light PAI, 0.32 (95% CI 0.12-0.82) for the moderate/moderately vigorous PAI, and 0.13 (95% CI 0.02-1.02) for the vigorous PAI when compared with subjects in the sedentary PAI (P < 0.05 for trend). The corresponding age-adjusted odds ratio was 0.28 (95% CI 0.14-0.57) for subjects in the moderate fitness category and 0.12 (95% CI 0.05-0.32) for the highest fitness category compared with those in the lowest fitness category (P < 0.001 for trend). Higher levels of physical activity or CRF were also associated with significantly lower age-adjusted odds ratios for the MS after exclusion of obesity in the MS definition. CONCLUSION: Overall, these cross-sectional results suggest that higher physical activity and predicted VO2max levels are associated with a decreased clustering of risk factors associated with the MS in middle-aged men of higher social class.     

Studies of a targeted risk reduction intervention through defined exercise (STRRIDE)

PURPOSE: The Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) trial is a randomized controlled clinical trial designed to study the effects of exercise training regimens differing in dose (kcal.wk-1) and/or intensity (relative to peak VO2) on established cardiovascular risk factors and to investigate the peripheral biologic mechanisms through which chronic physical activity alters carbohydrate and lipid metabolism to result in improvements in these parameters of cardiovascular risk in humans. METHODS: We will recruit 384 subjects and randomly assign them to one of three exercise training regimens or to a sedentary control group. The recruiting goal is to attain a subject population that is 50% female and 30% ethnic minority. The overall strategy is to use graded exercise training regimens in moderately overweight subjects with impairments in insulin action and mild to moderate lipid abnormalities to investigate whether there are dose or intensity effects and whether adaptations in skeletal muscle (fiber type, metabolic capacity, and/or capillary surface area) account for improvements in insulin action and parameters of lipoprotein metabolism. We will study these variables before and after exercise training, and over the course of a 2-wk detraining period. The study sample size is chosen to power the study to examine differences in responses between subjects of different gender and ethnicity to exercise training with respect to the least sensitive parameter-skeletal muscle capillary density. RESULTS: The driving hypothesis is that improvements in cardiovascular risk parameters derived from habitual exercise are primarily mediated through adaptations occurring in skeletal muscle. CONCLUSION: Identification that amount and intensity of exercise matter for achieving general and specific health benefits and a better understanding of the peripheral mechanisms mediating the responses in carbohydrate and lipid metabolism to chronic physical activity will lead to better informed recommendations for those undertaking an exercise program to improve cardiovascular risk.     

Safety of chronic exercise in a rat model of kidney disease

PURPOSE: The objective of this study was to determine the effect of treadmill running on polycystic kidney disease (PKD) progression and bone mineral density in Han:SPRD-cy rats, an animal model of PKD. METHODS: Using a 2 x 2 design, normal and polycystic male rats were divided randomly into exercise and sedentary groups at 4 wk of age. The exercising group performed treadmill exercise (14 m x min(-1)) for 30 min 3 d x wk(-1) for 6 wk, whereas the control group remained sedentary. This 6-wk period represents the period of greatest cyst growth in this model. RESULTS: Both exercised and sedentary polycystic animals had significantly greater kidney weights, as well as greater concentrations of serum urea nitrogen and serum creatinine than control animals. Exercise did not alter these parameters in either normal or polycystic animals. In addition, bone mineral density and bone mineral content, determined by dual-energy x-ray absorptiometry, were not altered by exercise in these animals. Bone mineral content, however, was marginally lower in polycystic animals. CONCLUSIONS: These results support the safety of moderate exercise in PKD. Additional research in this area is needed since there may be other benefits that are derived from exercise in this population.     

Stages of exercise behavior and caloric expenditure

BACKGROUND: This study assessed the ability of the stages of exercise behavior to differentiate caloric energy expenditure, by stage, based upon self-report of energy expenditure (EE). METHODS: Volunteer male and female participants (n=890) reported current stage of physical activity; physical activity mode, duration, and frequency; and demographic information (height and weight). Data calculated from reported information included EE, body mass index (BMI), and BMI category. EE profiles were established by average estimated EE (kcal/wk), average total time (min/wk) for physical activity, average activity frequency (times/wk), average session duration (min/session), moderate and vigorous EE levels (kcal/wk), and categorized activity level (sedentary, moderate, vigorous). RESULTS: There were no significant within gender differences across stages of exercise behavior for height. Terminators differed significantly for weight from all other groups, and BMI was significantly less across groups, by gender. All males were identified in the "Mildly Obese" BMI level, while only females in the non-active (precontemplation, contemplation, and preparation) groups were so identified. All other females were at the "Acceptable" BMI level. Regardless of gender, all groups were significantly different from the sedentary precontemplation and contemplation group for EE. Male and female preparation groups reported EE in the moderate level, and were significantly different from the action, maintenance, and termination groups, who reported EE in the vigorous level. Across subsequent stages of exercise behavior, female participants demonstrated increased EE. Male participants were similarly profiled, with the exception of one group (action stage), which was considerably greater than all other groups. CONCLUSIONS: This study confirmed the earlier examined premise, by Cardinal, that self-selected stage of exercise behavior differentiates EE by stage.     

Effect of pregnancy on heart rate/oxygen consumption calibration curves

PURPOSE: The purpose of this investigation was to determine heart rate (HR)/oxygen consumption (VO2) calibration curves for exercising and sedentary women during pregnancy and the postpartum periods. METHODS: Fifty-two women were studied at three time points: 20 wk gestation, 32 wk gestation, and 12 wk postpartum. Subjects were grouped either as regular exercisers (N = 27) or sedentary controls (N = 25). At each time point, each woman had HR and VO2 measured at rest (lying, seated, and standing) as well as during steady-state treadmill exercise performed at three increasing intensities. Flex HRs were defined and calculated by averaging the value seen during the lowest exercise intensity and highest value during rest. Individual HR/VO2 calibration curves were generated for exercise at each time point. Statistical analyses of all dependent variables included comparisons of subject groups (exercise and sedentary) and pregnancy status (20 wk, 32 wk, and 12 wk postpartum). RESULTS: Resting VO2 (mL.kg-1.min-1) was approximately 6.5% greater during pregnancy compared with postpartum conditions (P < 0.005). Also, both resting and flex HRs were greater during pregnancy compared with postpartum (P < 0.01). Resting HR was lower in exercising women compared with sedentary controls at all time points (P < 0.01). Slopes of HR/VO2 regression curves were flatter during pregnancy (P < 0.005), but there was no difference between groups. Y-intercepts were less at 20 wk compared with 36 wk postpartum. CONCLUSIONS: A woman's HR, VO2, and the relationship between these two parameters are altered during pregnancy. Change in slope of HR/VO2 regression curves indicates less energy expenditure at a given HR as pregnancy progresses, compared with postpartum conditions. A woman's true energy expenditure would be overestimated at rest, and underestimated during physical activity, if these physiological changes are not taken into account.     

核素心肌灌注显像诊断代谢综合征心肌缺血的研究

目的评估代谢综合征（Ms）患者心肌缺血及相关危险因素,探讨核素心肌灌注显像诊断冠心病的价值。方法140例住院患者分为3组：MS组（82例）,高血压病组（EH组,38例）,2型糖尿病组（T2DM组,20例）。3组均又分为运动负荷组和静息组,采用单光子发射计算机断层核素心肌灌注显像（SPECT MPI）的方法检测各组心肌缺血情况。结果MS组心肌缺血率为81．7％,重度缺血率为56．8％,均高于其他两组（P〈0．05）。核素检查运动负荷组缺血率为81．7％,明显高于静息组（P〈0．01）。BMI、腹围、血TG、血HDL-C与缺血有相关性。结论与EH组和T2DM组患者相比,MS组患者心肌缺血率和严重程度最高;其中MS某些组分与心肌缺血密切相关;心肌核素检查用于诊断早中期心肌缺血、判断中度危险的冠心病有临床价值。     

螺旋藻复方合剂对运动小鼠肝细胞、心肌和骨骼肌细胞超微结构及HSP70表达的影响

目的:研究螺旋藻复方对递增大负荷运动小鼠肝脏、心肌和骨骼肌的保护作用及对HSP70表达的影响.方法:用光学显微镜和电子显微镜分别观察递增大负荷运动和递增大负荷运动加螺旋藻复方对小鼠心肌、骨骼肌和肝组织的形态学影响.用免疫组化法(SP法)研究适量运动、递增大负荷运动、适量运动加螺旋藻复方和递增大负荷运动加螺旋藻复方对小鼠心肌细胞、骨骼肌细胞和肝细胞的HSP70蛋白表达的变化.结果:在光镜下,递增大负荷运动组小鼠心肌、骨骼肌和肝细胞出现了不同程度的水肿、变性和坏死,在电镜下,可见肌原纤维断裂、细胞肿胀、线粒体肿胀,空泡样变和细胞核核质溶解,可见凋亡小体.而递增大负荷运动加螺旋藻复方组小鼠心肌、骨骼肌和肝脏的病变程度明显减轻.运动各组小鼠心肌细胞、骨骼肌细胞和肝细胞HSP70表达均显著高于正常组(均P＜0.01),适量运动加螺旋藻复方组小鼠心肌细胞、骨骼肌细胞和肝细胞HSP70表达均高于适量运动组(P＜0.01或P＜0.05).递增大负荷运动加螺旋藻复方组小鼠心肌细胞、骨骼肌细胞和肝细胞HSP70表达均显著低于递增大负荷运动组(P＜0.01或P＜0.05),但与适量运动加螺旋藻复方组比较,无显著性差异(均P＞0.05).结论:螺旋藻复方能抵抗递增大负荷运动导致的组织细胞损伤,其分子机理可能与该方可提高运动诱导HSP70表达水平有关.     

不同强度运动对去卵巢大鼠股骨下端松质骨影响的扫描电镜观察

以成年大鼠去卵巢建立骨质疏松模型，利用扫描电镜观察了８周的中等强度和大强度跑台运动对去卵巢大鼠股骨下端松质骨超微形态结构的影响。结果：大鼠去卵巢后两种强度的运动均比非运动组大鼠骨小梁数目增多，以中等强度运动更明显；骨小梁厚度增加，以大强度组更明显，大强度组骨小梁发生片层状改变。中等强度运动组骨吸收面积减小，骨小梁表面骨胶原纤维排列更整齐。大强度组裂纹及微骨折增多。结论：中等强度运动对去卵巢大鼠股骨下端松质骨超微结构产生了更好的作用。