唐湘宇、洪华山、谭华清、林晓红、杨志远、陈良龙.不同时间窗介入运动训练对心肌梗死大鼠生存率及左室心功能变化的影响[J].中华物理医学与康复杂志,2016,38(5):321-324
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| 不同时间窗介入运动训练对心肌梗死大鼠生存率及左室心功能变化的影响 |
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| DOI： |
| 中文关键词: 运动训练 心肌梗死 左室功能 生存率 |
| 英文关键词: Exercise Myocardial infarction Left ventricular function Survival rate |
| 基金项目:国家自然科学基金项目（30940077）；湖南省科技厅项目（2013FJ3064） |
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| 中文摘要: |
| 目的 探讨不同时间窗介入运动训练对心肌梗死大鼠生存率及左室心功能变化的影响。 方法 选取健康雄性SD大鼠96只，按照随机数字表法将大鼠分为假手术不运动组、假手术前运动组、心梗不运动组、心梗前运动组、心梗后运动组、心梗前后联合运动组，每组16只。所有大鼠均接受急性心肌梗死造模手术或假手术。假手术不运动组大鼠假手术前后均不运动；假手术前运动组大鼠假手术前采用跑台训练5周，术后不进行运动训练；心梗不运动组大鼠在心肌梗死前后均不进行运动训练；心梗前运动组大鼠心肌梗死前采用跑台训练5周，术后不再进行运动训练；心梗后运动组大鼠心肌梗死前不进行运动训练，心肌梗死4周后采用跑台训练8周；心梗前后联合运动组大鼠心肌梗死前采用跑台训练5周，心肌梗死4周后采用跑台训练8周。上述所有运动训练每周5d，每日60min。术后4d、2周、4周、8周、12周，观察记录各组大鼠的生活情况及自发死亡率，到达实验终点前对其进行超声心动图检测，然后处死所有大鼠。 结果 假手术后4d，与假手术不运动组同时间点比较，心梗不运动组大鼠4d、2周、4周、8周及12周时的舒张末期左室内径（LVEDd）及收缩末期左室内径（LVEDs）较大，左室短轴缩短率（FS）及射血分数（EF）较低，差异均有统计学意义（P<0.05）。与心梗不运动组同时间点比较，心梗前运动组4d时LVEDd及LVEDs较小，FS及EF较高，差异有统计学意义（P<0.05），2周时LVEDs较小，FS及EF较高，差异有统计学意义（P<0.05）。与心梗不运动组同时间点比较，心梗后运动组12周时FS、EF显著较高，差异有统计学意义（P<0.05）。心梗前后联合运动组4d时LVEDd及LVEDs较心梗不运动组小，FS及EF较高（P<0.05）。心梗前后联合运动组2周、8周、12周时LVEDs较心梗不运动组小，FS及EF较高（P<0.05）。与心梗前运动组同时间点比较，心梗前后联合运动组12周时LVEDs［（4.71±0.2）mm］较小，FS［（38.7±2.7）%］及EF［（62.7±3.2）%］较高（P<0.05）。 结论 心梗前运动可改善心梗后早期大鼠的心脏功能，但对于心梗晚期大鼠左室功能的改善效果并不明显，心梗后运动可改善心梗后晚期大鼠的左室功能，心梗前后联合运动可改善心梗后早期及晚期大鼠的左室功能。 |
| 英文摘要: |
| Objective To study the effects of exercise after myocardial infarction on the survival rate and the dynamic functioning of the left ventricle (LV). Methods Ninety-six male Sprague-Dawley rats were randomly assigned to a sedentary sham operation group (Sed-Sh), a previous exercise and sham operation group (PreE-Sh), a sedentary myocardial infarction (MI) group (Sed-MI), a previous exercise MI group (PreE-MI), a post exercise MI group (PostE-MI) and a combined exercise MI group (ComE-MI), each of 16.All of the rats underwent either MI induction or a sham MI operation, the PreE groups after exercising for 5 weeks on a treadmill. The Sed groups did not exercise. The Post E-MI group did not exercise before the operation, but performed treadmill exercises for 4 weeks beginning 8 weeks after the operation. The ComE-MI group exercised for 5 weeks before and 4 weeks after the operation. All the exercising rats ran on the treadmill for 60 minutes daily, 5 d/wk. Life situation and spontaneous mortality were recorded, and echocardiographic measurements were performed on the4thday and 2, 4, 8 and 12weeks after the operation. All of the rats were sacrificed at the end of the experiment. Results Compared with the Sed-Sh group, the Sed-MI group had significantly larger average LV dimensions at the end of both the diastol (LVEDd) and the systol (LVEDs, but it had lower average fractional shortening (FS) and a smaller average ejection fraction(EF) at all of the different measuring times. The PreE-MI group had significantly lower average LVEDd and LVEDs, but a significantly higher FS and EF than the Sed-MI group on the 4th day. However, 2 weeks after the intervention the difference in LVEDd between the two groups was no longer significant. Significantly higher FS and EF were observed in the PostE-MI group at 12 weeks compared to the Sed-MI group. The ComE-MI group had significantly lower average LVEDd and LVEDs, but significantly higher FS and EF at all the time points than the Sed-MI group. The ComE-MI group had a significantly lower average LVEDs but a higher average FS and EF than the PreE-MI group at 12 weeks after the intervention. Conclusion Pre-MI exercise improves LV function significantly at the early stage, though the difference is temporary. Post-MI exercise improves LV function in the longer term. Combined exercise improves LV function the most effectively. |
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