Wosornu D, Allardyce W, Ballantyne D, Tansey P
Department of Cardiology, Victoria Infirmary, Glasgow.
Br Heart J. 1992 Aug;68(2):181-6. doi: 10.1136/hrt.68.8.181.
To determine the effects of aerobic and power exercise training on haemostatic factors after coronary artery surgery and to compare the effect of the two exercise programmes.
A prospective randomised controlled study of six months aerobic and power exercise training in men after coronary artery surgery.
Exercise rehabilitation classes in a teaching hospital in Glasgow.
55 men within 12 months of coronary artery surgery recruited from surgical centres and medical clinics and asked to participate in the study.
Assessments, including a treadmill test, measurements of haemoglobin, platelet, fibrinogen, factor VIIc, and fibrinopeptide A concentrations, and packed cell volume, done at baseline, three months, and six months. Patients in the two exercise groups attended training sessions three times weekly for six months. Control patients had no formal exercise training but continued with their leisure time activities.
Exercise performance on a treadmill, haematology, and haemostatic factor assays at baseline, three months, and six months.
In the aerobic trained group exercise performance increased significantly over baseline at three months (interval change 146.7, 95% confidence interval (95% CI) 52.5 to 240.9 s, p = 0.003) and was maintained at six months (interval change 172.1, 95% CI 63.3 to 280.9 s, p = 0.002). In the power trained groups significant improvement in exercise performance was delayed until six months (interval change 99.9 s, 95% CI 20.3 to 170.5 s, p = 0.01). Exercise performance in the control did not change significantly. Haemoglobin, concentration, packed cell volume, and platelet counts did not change significantly at any time. Fibrinogen concentration was significantly lower in the aerobic group than the other two groups at three months (2.96 g/dl compared with 3.3 g/dl and 3.87 g/dl in the power and control groups, p = 0.01). The power group had a lower fibrinogen concentration than the control group (p = 0.04). The lower fibrinogen concentration in the aerobic group was maintained at six months. There was a gradual rise in factor VIIc concentrations in the aerobic and control groups compared with a small fall in the power group. Fibrinopeptide A concentrations showed no consistent changes.
Aerobic exercise training after coronary artery surgery causes an early favourable change in treadmill performance and in fibrinogen concentrations, that is maintained with further training. Power exercise training causes delayed benefit in treadmill performance. It also causes a small fall in fibrinogen concentrations. These changes may be relevant in reducing cardiovascular morbidity from graft failure and occurrence of myocardial infarction after coronary artery surgery.
确定有氧运动训练和力量训练对冠状动脉搭桥术后止血因子的影响，并比较这两种运动方案的效果。
一项对冠状动脉搭桥术后男性进行为期6个月有氧运动训练和力量训练的前瞻性随机对照研究。
格拉斯哥一家教学医院的运动康复课程。
从外科中心和诊所招募55名在冠状动脉搭桥术后12个月内的男性，并邀请他们参加研究。
在基线、3个月和6个月时进行评估，包括跑步机测试、血红蛋白、血小板、纤维蛋白原、因子VIIc和纤维蛋白肽A浓度以及红细胞压积的测量。两个运动组的患者每周参加3次训练课程，为期6个月。对照组患者没有进行正规的运动训练，但继续进行他们的休闲活动。
基线、3个月和6个月时的跑步机运动表现、血液学和止血因子检测。
在有氧运动训练组，3个月时运动表现较基线显著提高（间隔变化146.7，95%置信区间（95%CI）52.5至240.9秒，p = 0.003），6个月时保持这一水平（间隔变化172.1，95%CI 63.3至280.9秒，p = 0.002）。在力量训练组，运动表现的显著改善延迟至6个月（间隔变化99.9秒，95%CI 20.3至170.5秒，p = 0.01）。对照组的运动表现没有显著变化。血红蛋白浓度、红细胞压积和血小板计数在任何时候都没有显著变化。3个月时，有氧运动组的纤维蛋白原浓度显著低于其他两组（分别为2.96g/dl，力量训练组和对照组分别为3.3g/dl和3.87g/dl，p = 0.01）。力量训练组的纤维蛋白原浓度低于对照组（p = 0.04）。有氧运动组较低的纤维蛋白原浓度在6个月时得以维持。有氧运动组和对照组的因子VIIc浓度逐渐升高，而力量训练组则略有下降。纤维蛋白肽A浓度没有一致的变化。
冠状动脉搭桥术后进行有氧运动训练可使跑步机运动表现和纤维蛋白原浓度早期出现有益变化，并在进一步训练中得以维持。力量训练对跑步机运动表现的益处出现较晚。它还会使纤维蛋白原浓度略有下降。这些变化可能与降低冠状动脉搭桥术后移植血管失败和心肌梗死导致的心血管疾病发病率有关。
