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[冠状动脉旁路移植术后患者的运动训练与勃起功能障碍]

[Exercise training and erectile dysfunction in patients after coronary artery bypass grafting].

作者信息

Pomeshkina S A, Barbarash O L, Pomeshkin E V

机构信息

Research Institute for Complex Issues of Cardiovascular Diseases.

Kemerovo State Medical University.

出版信息

Ter Arkh. 2019 Sep 15;91(9):16-20. doi: 10.26442/00403660.2019.09.000149.

Abstract

AIM

to estimate the effects of exercise training on erectile function after coronary artery bypass grafting.

MATERIALS AND METHODS

114 men with stable coronary artery disease undergoing on - pump coronary artery bypass grafting were examined. Patients with ED were randomized into two groups comparable in the main demographic, clinical and baseline parameters: a group of patients undergoing supervised exercise trainings at the outpatient rehabilitation center (n=53) and a group of patients without any exercise trainings at the outpatient hospital (n=61). Patients were assessed 1, 6 and 12 months after CABG. All patients underwent echocardiography (ECHO-CG), bicycle ergometer test without discontinuation of the drug therapy, measurement of nocturnal penile tumescence (NPT), ultrasound assessment of the cavernous arteries with the further estimation of their endothelial function.

RESULTS

In addition to the expected improvements in exercise tolerance, regular cycling exercises led to a significant recovery of erectile function (number and duration of NTP, increased penile blood flow volume, estimated during NTP measurement), improved endothelial function of the cavernous arteries, compared to patients without exercise trainings. However, the obtained effects in the group with exercise trainings were short - term. One year after CABG, the number of NTP and penile blood flow volume were superior in patients undergoing exercise trainings. Differences in other parameters became less reliable between the groups.

CONCLUSION

Aerobic exercise trainings appeared to be effective for optimizing exercise tolerance, erectile and endothelial function, and allow improving the prognosis of these patients and, therefore, are needed to be included in the rehabilitation programs for patients undergoing CABG.

摘要

目的

评估运动训练对冠状动脉搭桥术后勃起功能的影响。

材料与方法

对114例接受体外循环冠状动脉搭桥术的稳定型冠心病男性患者进行检查。将勃起功能障碍患者随机分为两组,两组在主要人口统计学、临床和基线参数方面具有可比性:一组患者在门诊康复中心接受监督下的运动训练(n = 53),另一组患者在门诊医院不进行任何运动训练(n = 61)。在冠状动脉搭桥术后1、6和12个月对患者进行评估。所有患者均接受超声心动图检查(ECHO - CG)、在不中断药物治疗的情况下进行自行车测力计测试、夜间阴茎勃起测定(NPT)、海绵体动脉超声评估并进一步评估其内皮功能。

结果

除了运动耐量有预期改善外,与未进行运动训练的患者相比,定期骑自行车运动导致勃起功能显著恢复(NTP的次数和持续时间、NTP测量期间估计的阴茎血流量增加),海绵体动脉内皮功能改善。然而,运动训练组获得的效果是短期的。冠状动脉搭桥术后一年,接受运动训练的患者NTP次数和阴茎血流量更高。两组之间其他参数的差异变得不太可靠。

结论

有氧运动训练似乎对优化运动耐量、勃起和内皮功能有效,并有助于改善这些患者的预后,因此需要纳入冠状动脉搭桥术患者的康复计划中。

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