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目的研究有氧运动对不稳定性心绞痛患者的胰高血糖素样肽-1(GLP-1)等因子的影响,为有针对性地建议不稳定性心绞痛患者进行有氧运动提供依据。方法选取2014年1-12月天津市胸科医院心内科160例已确诊为不稳定性心绞痛的患者为研究对象,男性81例,女性79例,年龄60~80岁,平均(61.2±1.2)岁,随机分为运动组(80例)和对照组(80例),运动组接受单硝酸异山梨酯片(欣康20 mg,3次/d)或单硝酸异山梨酯缓释片(索尼特60 mg,1次/d)、琥珀酸美托洛尔缓释片(倍他乐克23.75~47.50 mg,1次/d)和阿托伐他汀钙(立普妥20~40 mg,每晚1次)或瑞舒伐他汀钙(可定5~10 mg每晚1次),并附加有氧运动,对照组仅接受西医治疗不附加有氧运动,比较两组患者治疗前后生化指标的变化。采用SPSS 17.0软件进行χ2检验、配对样本t检验、独立样本t检验或秩和检验。结果治疗前,运动组与对照组患者的GLP-1、半胱氨酸(Hcy)、血清超敏C反应蛋白(hs-CRP)水平等的差异均无统计学意义(P>0.05)。经过6个月治疗后,运动组治疗后血糖、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、Hcy和hs-CRP水平均明显低于本组治疗前和对照组治疗后,差异均有统计学意义(P<0.05)。对照组治疗后TG、LDL-C、Hcy和hs-CRP水平均明显低于本组治疗前,差异均有统计学意义(P<0.05)。运动组患者治疗后的GLP-1水平[(34.71±1.32)pmol/L]明显高于本组治疗前[(28.58±1.01)pmol/L]和对照组治疗后[(30.94±1.77)pmol/L],差异均有统计学意义(P<0.05)。对照组治疗后GLP-1水平明显高于本组治疗前[(29.11±1.59)pmol/L],差异有统计学意义(P<0.05)。心电图结果显示,运动组显效和有效人数(分别为35、40例)明显高于对照组(分别为20、32例),差异有统计学意义(P<0.01)。结论有氧运动能够降低不稳定性心绞痛患者的血清hs-CRP、Hcy水平,能够有效地提高GLP-1水平,对降低不稳定性心绞痛患者的发病风险起到了积极的作用。
Objective To study the effects of aerobic exercise on glucagon-like peptide-1 (GLP-1) and other factors in patients with unstable angina pectoris and to provide evidence for the targeted aerobic exercise in patients with unstable angina pectoris. Methods From January to December 2014, 160 patients with unstable angina pectoris who were diagnosed as unstable angina at Tianjin Chest Hospital were enrolled in this study. There were 81 males and 79 females, aged from 60 to 80 years (mean, 61.2 ± 1.2) Year old were randomly divided into exercise group (n = 80) and control group (n = 80). The exercise group received isosorbide mononitrate tablets (Xinkang 20 mg, 3 times daily) or isosorbide mononitrate sustained release tablets 60 mg once daily) metoprolol succinate sustained-release tablets (metoprolol 23.75 to 47.50 mg once daily) and atorvastatin calcium (20 to 40 mg per liter) Night 1) or rosuvastatin calcium (5 ~ 10 mg per night), and aerobic exercise, the control group received only Western medicine without aerobic exercise, the two groups before and after treatment compared biochemical markers Variety. SPSS 17.0 software was used for χ 2 test, paired sample t test, independent sample t test or rank sum test. Results Before treatment, the levels of GLP-1, Hcy and hs-CRP in exercise group and control group were not significantly different (P> 0.05). After 6 months of treatment, the levels of blood glucose, total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), Hcy and hs-CRP in the exercise group were significantly lower than those in the treatment group Before and after treatment, the differences were statistically significant (P <0.05). The levels of TG, LDL-C, Hcy and hs-CRP in the control group after treatment were significantly lower than those before treatment in this group (P <0.05). The level of GLP-1 in the exercise group was significantly higher than that in the control group [(34.71 ± 1.32) pmol / L [(28.58 ± 1.01) pmol / L and [30.94 ± 1.77 pmol / L], the differences were statistically significant (P <0.05). The level of GLP-1 in the control group was significantly higher than that of the control group before treatment [(29.11 ± 1.59) pmol / L], the difference was statistically significant (P <0.05). The results of electrocardiogram showed that the effective and effective number of exercise group (35 and 40 cases, respectively) were significantly higher than that of the control group (20 and 32 cases, respectively), the difference was statistically significant (P <0.01). Conclusions Aerobic exercise can reduce serum hs-CRP and Hcy levels in patients with unstable angina and improve GLP-1 level effectively, which plays a positive role in reducing the risk of developing unstable angina.