有氧训练对缺血性卒中危险因素的干预

美同心脏协会/美国卒中协会的缺血性卒中一级预防指南将体力活动缺乏列为一项证据充分的可干预危险因素.以往研究表明,有氧训练可降低高血压患者或非高血压人群的血压水平,前者的血压下降更为显著;在偏瘫患者中也观察到有氧训练组收缩压显著下降.有氧运动是目前公认的治疗糖尿病的运动疗法之一.运动可提高胰岛素的敏感性,提高葡萄糖的利用率,从而降低血糖水平.超过一定阈值的运动能调节高密度脂蛋白胆固醇和三酰甘油水平,延缓颈动脉内膜中膜厚度的增加,降低高敏C-反应蛋白和血管细胞黏附分子-1水平,对内源性纤维蛋白溶解有即刻效应.因此,通过生活方式调节,特别是增加有氧运动来预防卒中已得到公认,而卒中患者能否通过积极的有氧训练达到对卒中危险因素的干预以及能否最终达到预防卒中复发的目的,还有待进一步的研究证实.

Intervention of aerobic training on the risk factors for ischemic stroke

The American Heart Association/American Stroke Association Guidelines for Primary Prevention of Stroke has listed physical inactivity as a well-documented and modifiable risk factor. Previous studies have shown that aerobic training could reduce the blood pressure levels in patients with hypertension or non-hypertensive population, especially in the former; the significantly decreased systolic pressure in patients with hemiplegia was also observed in the aerobic training group. Currently, aerobic exercise is recognized as one of the exercise therapies for diabetes. Exercise can enhance the sensitivity of insulin, and improve the utilization rate of glucose, thereby reducing the blood glucose level. Exercise over a certain threshold can regulate the levels of high-density lipoprotein cholesterol and triglyceride, delay the increased carotid artery intima-media thickness, reduce the levels of high-sensitivity C-reactive protein and vascular cell adhesion molecule-1, and have immediate effects on endogenous fibrinolysis. Therefore, by regulating lifestyle, particularly by increasing aerobic exercise to prevent stroke has been recognized, and whether the patients with stroke can achieve the intervention of the risk factors for stroke by the active aerobic training, as well as whether they can ultimately achieve the purpose of preventing stroke recurrence are still need to be confirmed by further studies.