健步走锻炼对原发性高血压病患者自主神经功能的影响

[目的]探讨高血压病的自主神经发病机理,以及有氧运动防治高血压病的自主神经机制。[方法]25名61～65岁健康妇女作为正常对照组,50名61～65岁高血压病妇女,随机分为高血压运动组和高血压对照组,高血压运动组进行健步走锻炼12周（每周3次,每次1 h,运动强度46%～60?）。实验开始前后,测试血浆去甲肾上腺素（NE）、肾上腺素（E）和血清乙酰胆碱酯酶（ACHE）活性,以及心率变异性（HRV）。[结果]实验前,与正常对照组相比,高血压病患者血浆NE、E增高,HRV参数LF、LF/HF上升,HF下降。健步走锻炼3个月后,血浆NE、HRV参数LF和LF/HF下降且低于高血压对照组,HF上升且高于高血压对照组,并且各指标趋于接近正常对照组水平。HRV测试过程中,各组在安静状态下没有显示的差异,可在运动状态和深呼吸状态下得以显现。[结论]自主神经失衡与高血压病发病机理存在一定的联系,健步走锻炼可通过纠正高血压病患者的自主神经失衡,达到治疗高血压病的目的。在动态负荷状态下测试HRV可实现对自主神经功能较为全面准确的评价。

THE EFFECT OF WALKING ON AUTONOMIC NERVOUS SYSTEM OF PATIENTS WITH PRIMARY HYPERTENSION

[Objective]To investigate the pathogenesis of primary hypertension and the effect of aerobic exercise on autonomic nervous system of primary hypertension patients.[Methods]25 healthy women aged from 61 to 65 were selected as normal control group,and 50 female patients with primary hypertension were divided into two groups:experiment group and control group of hypertension.Patients in experiment group took aerobic exercises(walking)regularly for 12 weeks(3 times/week,1 hour/time).The heart rate variability(HRV),plasma norepinephrine and plasma epinephrine and acetylcholine esterase were measured before and after experiment.[Results]The plasma epinephrine,norepinephrine,LF and LF/HF in hypertension groups were higher,and HF was lower than those in normal control group before experiment.After 12 weeks,plasma epinephrine,LF and LF/HF decreased obviously in experiment group of hypertension,which was lower than that of control group of hypertension.HF in experiment group of hypertension increased and exceeded that of control group of hypertension.[Conclusion]Unbalance of autonomic nervous conttributes to primary hypertension.Longtime regular aerobic exercise can correct the unbalance of autonomic nervous of patients with primary hypertension to cure hypertension.The testing protocol of HRV used in this study can reveal some characters which are inconspicuous on resting state,which can increase the sensitivity of HRV analysis effectively.