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目的 探讨运动锻炼对高血压伴单纯左室舒张功能不全患者心功能及血脑钠肽的影响.方法 将66例高血压伴单纯左室舒张功能不全患者随机分为干预组和对照组.干预组在药物治疗基础上给予为期6个月的运动锻炼,对照组药物治疗同前,并保持平静生活方式.结果 通过6个月的运动锻炼,干预组与对照组比较:体重[(68 ±7)、(72±8)]kg；收缩压[(135.4±5.1)、(140.9±5.2)] mm Hg(1 mm Hg=0.133 kPa)、舒张压[(81.1±4.0)、(84.7 ±4.6)]mm Hg;纽约心脏学会分级(1.4±0.3)、(1.8±0.4)；N-端B型钠尿肽原[ (526±126)、(741±189)] ng/L明显下降；左室射血分数(62.9±6.7)、(59.O±5.6),E/A( 1.1±0.3)、(0.9±0.3)明显升高(均P＜0.05).结论 运动锻炼明显降低高血压伴单纯左室舒张功能不全患者血压、体重,同时改善心脏功能,是简单易行的健康教育项目.

Objective To investigate the effects of physical exercises on cardiac function and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in hypertensive patients combined with diastolic cardiac dysfunction.Methods A total of 66 essential hypertension patients who had abnormal left ventricular relaxation and normal systolic function were assigned to the intervention group ( n =33 ; doing physical exercises once a day,5 days a week) or control group (n =33 ).All the patients received standard treatment.At 6 months,body weight,blood pressure,heart rate,NT-proBNP,and echocardiography were measured.Results At 6 months,body weight [ (68 ± 7 ) kg vs (72 ± 8 ) kg ],systolic blood pressure [ (135.4 ±5.1) mm Hg (1 mm Hg =0.133 kPa) vs (141.9 ±5.2) mm Hg ],diastolic blood pressure [ (81.1 ±4.0) mm Hg vs (84.7 ±4.6) mm Hg],New York Heart Association class (1.4 ±0.3 vs 1.8 ±0.4),NT-proBNP level [ (526 ± 126 ) ng/L vs (741 ± 189 ) ng/L] were significantly decreased in the intervention group when compared with the control group ( all P ＜ 0.05 ) although left ventricular ejection fraction (LVEF) (62.9 ±6.7 vs 59.0 ±5.6) and E/A ratio ( 1.1 ±0.3 vs 0.9 ±0.3) were significantly increased ( both P ＜ 0.05).Conclusion Physical exercises could play a role in reduced blood pressure and body weight and improved cardiac function in hypertensive patients with diastolic cardiac dysfunction.