摘要目的 探讨采用手握法进行等张抗阻训练对高血压缺血性小卒中患者血压变异性及心率变异性的影响.方法 将125例高血压缺血性小卒中患者按随机数字表法分为对照组60例和干预组65例,对照组实施常规神经内科护理措施,干预组在对照组的基础上采用手握法进行等张抗阻训练干预.采用TM-2430型无创便携式动态血压监测仪及PI200A-A动态心电监测仪进行24 h动态血压及动态心电监测,对2组患者的血压变异性及心率变异性进行评估.结果 干预后,干预组24 h收缩压变异系数和24 h舒张压变异系数分别为(10.16±1.95)、(12.6±7.15)％,对照组分别为(12.92±2.79)、(17.38±4.49)％,2组比较差异有统计学意义(t=6.450、4.435,均P<0.05);干预组的正常窦性R-R问期的标准差、全程相邻R-R问期之差的均方根值、全程内差值超过50 ms的连续正常R-R问期所占的百分率、三角指数4项分别是(173.3±58.5)ms、115.9±74.4、(54.8±24.1)％、53.3±15.1,对照组分别是(128.7±40.2)ms、82.1±35.2、(39.9±17.1)％、30.6±14.9,2组比较差异有统计学意义(t=-8.439～-3.207,均P<0.05).结论 采用手握法进行等张抗阻训练能有效降低高血压缺血性小卒中患者的血压变异性,提高其心率变异性,利于疾病的恢复.

abstractsObjective The present study aimed to evaluate the effects of isometric resistance training(IRT)conducted using handgrip exercise on blood pressure variability (BPV) and heart rate variability (HRV) in hypertensive patients with minor ischemic stroke (MIS).Methods One hundred and twenty-five hypertensive patients with MIS were included in the present study. Patients were randomized into two groups with random number table. Patients in the control group (n=60) were nursed in the routine care in department of neurology, while patients in the experimental group (n=65) received the IRT.The 24-hour ambulatory blood pressure-monitoring assessment was performed using validated oscillometric recorders (A&D TM- 2430, A&D Inc.,Tokyo,Japan).The 24- hour ambulatory electrocardiography measurement was performed using electrocardiocorder(PI200A-A, QunTian Inc.,Shanghai,China).The BPV ratio and the HRV ratio were assessed in the two groups. Results 24 hours after the intervention, intervention group 24 hours systolic blood pressure variation coefficient and diastolic blood pressure variation coefficient were(10.16 ± 1.95)％,(12.6 ± 7.15)％,the control group, respectively (12.92 ± 2.79)％, (17.38±4.49)％, two groups compare the difference was statistically significant (t=6.450, 4.435, P<0.05). Intervention group of normal sinus R- R period between the standard deviation, to the phase difference between adjacent R- R , root mean square value of the whole difference in more than 50 ms continuous period of percentage between normal R-R and triangle Index were (173.3±58.5) ms, (115.9±74.4), (54.8± 24.1)％, (53.3 ± 15.1).The control group was(128.7 ± 40.2)ms, (82.1 ± 35.2),(39.9 ± 17.1)％, (30.6 ± 14.9), and the difference between the two groups was statistically significant(t=-8.439--3.207, all P<0.05). Conclusions Isometric resistance training conducted using handgrip exercise could increase the HRV and decrease the BPV in hypertensive patients with MIS. These results indicated that the IRT may improve the life quality of hypertensive patients with MIS.