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1、北京体育大学硕士学位论文等张运动与第长运动对高血压患者的心血管反应及脂蛋白代谢 的影响姓名：刘向辉申请学位级别：硕士专业：运动人体科学指导教师：刘桂华200505227英文缩写词表 英文缩写词表 WHO/ISH the world health organization/international society of hypertension 世界卫生组织/国际高血压联合会 SBP systolic blood pressure 收缩压 DBP diastolic blood pressure 舒张压 PP pulse pressure 脉压差 ET-1 endothelin-1 内皮素 H
2、DL-C high-density lipoprotein-cholesterol 高密度脂蛋白胆固醇 LDL-C low-density lipoprotein-cholesterol 低密度脂蛋白胆固醇 TC total cholesterol 总胆固醇 TG total glycerides 总甘油三酯 RPE rating of perceived exertion 主观用力感觉 HR heart rate 心率 THR target heart rate 靶心率 MVC maximum voluntary contraction 最大随意收缩 ETT exercise tolerat
3、e test 运动耐量实验 ANP atrial natriuretic peptide 心房利钠肽 Ang angiotensin 血管紧张素 3摘 要摘 要目的目的：探讨等张运动与等长运动对高血压患者的降压效果及脂蛋白代谢和内皮素的影响，为高血压患者选择科学的运动方式进行运动康复训练提供理论依据。方法方法：45 例中老年原发性高血压患者符合 1999 年 WHO/ISH 制定的高血压诊断标准，收缩压（SBP）为 130-200mmHg，舒张压（DBP）为 90-120mmHg。经 6 周预试验筛选合格者。采用相同的靶心率和相同的运动时间，将受试者随机分成 A、B、C三组采用不同的运动方案，
4、A组为等张练习，B组为等长练习，C 组为等长练习等张练习。等张运动训练采用功率自行车，运动负荷设定为50W，通过脚踏速度维持靶心率的运动强度并持续运动 20 分钟。等长运动训练使用下肢肌力测量练习器（calibrated leg dynamometer）,下肢伸展抗阻运动，以靶心率的运动强度为目标值，左右腿每 30交替进行，并持续 20 分钟。运动强度采用的靶心率的计算方法为：THR=（最大心率安静心率）0.60.85安静心率；同时用 RPE 监控运动强度。运动时间：40-50 分钟/次；运动频率：3次/周。三组主要基线资料具有可比性。观察运动康复训练 16 周前后安静状态下的血压、血脂及血浆
5、内皮素的变化。结果结果：每组高血压病患者性别、年龄、病程、体重及心血管病家族史等方面均衡，组间比较无显著性差异（P0.05） 。单纯的等张练习和单纯的等长练习均能使受试者的 SBP 和 DBP 降低，且与训练前比较有显著性差异（P0.05） ，但对于受试者的脉压差（PP）的影响在训练前后没有显著性的差异（P0.05） ；而等张练习与等长练习相结合的力量训练方案不但使受试者的 SBP 和 DBP 在训练后显著降低（P0.01） ，而且能使受试者的脉压差在训练后显著降低（P0.05） 。所有受试者运动训练后血压降低、血脂水平得以改善，其中以 C 组最为明显（P0.01）单纯的等张练习和单纯的等长练
6、习均能使受试者的血浆内皮素显著降低（P0.05） ，但两组之间没有显著性差异（P0.05） ；而等张练习与等长练习相结合力量训练方案使受试者在训练后血浆内皮素显著下降（P0.01） ，且与 A 组和 B组之间均存在显著性差异（P0.05） 。4结论结论：单纯的等张运动训练或单纯的等长运动训练对高血压患者在一定程度上均可以降低血压、改善其血脂代谢与血管的内皮功能，但等长运动与等张运动相结合的全面康复训练方案效果更好，是高血压运动处方的首选。关键词关键词：高血压；等长运动；等张运动；心血管反应；血脂；血浆内皮素；运动康复5Responses of cardiovascular and plasma
7、 lipid to isotonic exercise andisometric exercise in hypertensionAbstractObjective: To evaluate the responses of blood pressure ， plasma lipid plasmaendothelin to isotonic exercise and isometric exercises, to explore the possibility andthe necessity of applying the isotonic exercise and isometric ex
8、ercise in the exerciseprescription of hypertension, and give the theory foundation for making exerciseprescription for hypertension.Methods: Forty-five old age hypertension according to the diagnostic standard ofhypertension constituted by WHO/ISH in 1999 were randomized into group A, group Band gro
9、up C, whose SBP is between 130 to 200 mmHg, whose DBP is between 90 to120mmHg, and all of them were screened by the 6 weeks preliminary experimentation.With target heart rates and equal exercise times different exercise projects were carriedout, and isotonic exercise for group A, isometric exercise
10、for group B, isotonic exerciseand isometric exercise for group C. Isotonic exercise project adopted the power cycle,and the training load is 50W, and maintained the THR exercise intensity through thespeed of foot treadmill and went on for 20 minutes. Isometric exercise projectemployed the calibrated
11、 leg dynamometer, lower limbs were stretched to withstand theresistance, and the THR also is exercise intensity, the right leg and the left legcontracted by turns and went on for 20minutes.The method of reckon the THR forexercise intensity: THR=(HRmax-HRrest) 0.60.85HRrest; and at the same timeto su
12、rveillance the exercise intensity by RPE. The time of training is 40-50 minutes andthe training frequency is 3 times per week. Patients in the three groups were wellmatched in terms of basic data. Both sixteen weeks exercise-included changes in heartrate, blood pressure and plasma lipid were observe
13、d.Result:The gender, age, course of diseases, avoirdupois, and the family history ofcardiovascular disease in every group were in equilibrium, and there is no markeddifference(P0.05)among every group of them.6Single isotonic exercise and single isometric exercise all can lower the SBP andDBP of hype
14、rtension, and there are marked difference between the fore-and-aftexercise （P0.05） ，but there is no marked difference in PP between fore-and-aftexercise （P0.05）;But the group C not only can lower the SBP and DBP ofhypertension markedly after exercise（P0.01） ，but also can lower the PP ofhypertension
15、markedly after exercise （P0.05）.The blood pressure of all objects was appreciably lowered, and the level of plasmalipid was proved, it is more remarkable in group C（P0.01）.Single isotonic exercise and single isometric exercise all can lower the plasmaendothelin of hypertension markedly（P0.05）, yet t
16、here is no marked differencebetween the fore-and-aft exercise （P0.05）;but there is marked difference in groupC between fore-and-aft exercise （P0.01）;and there is marked difference betweengroup C and group A or between group C and group B（P0.05）.Conclusion: isotonic exercise and isometric exercise can improve the plasmalipid to a certain extent, can reduced the blood pressure evidently, and the all roundedtraining including isotonic exercise and isomet
