Kubo H, Ohshima H, Hirai H, Yabuki S, Machii K, Sato K, Ebine K
Third Department of Internal Medicine, Toho University School of Medicine, Tokyo.
J Cardiol. 1993;23(4):319-27.
This study evaluated the effect of physical exercise training on graft patency after aortocoronary bypass grafting (ACBG). Patients who underwent ACBG were randomized into the training (17 patients, 43 grafts) and nontraining groups (18 patients, 45 grafts). Tissue plasminogen activator (TPA) antigen, TPA activity, plasminogen activator inhibitor-1 (PAI-1) antigen and PAI-1 activity as fibrinolysis variables, and an angiographic study were performed 2 and 26 weeks after ACBG. Plasma TPA activity increased significantly in the training group, but not in the nontraining group after 24 weeks of training. Plasma PAI-1 antigen and activity decreased significantly in the training group, while PAI-1 levels remained unchanged in the nontraining group. Grafts were patent in 93% (40 of 43) of the training group and 76% (34 of 45) of the nontraining group (p < 0.05). A high plasma concentration of PAI-1 may interfere with the natural thrombolytic process. Exercise training can decrease PAI-1 levels and increase TPA activity after ACBG. Improved fibrinolysis obtained by exercise training may have beneficial effects on graft patency.
本研究评估了体育锻炼训练对主动脉冠状动脉旁路移植术（ACBG）后移植血管通畅情况的影响。接受ACBG的患者被随机分为训练组（17例患者，43条移植血管）和非训练组（18例患者，45条移植血管）。在ACBG术后2周和26周进行了组织纤溶酶原激活物（TPA）抗原、TPA活性、纤溶酶原激活物抑制剂-1（PAI-1）抗原和PAI-1活性作为纤溶变量的检测，并进行了血管造影研究。训练24周后，训练组血浆TPA活性显著增加，而非训练组未增加。训练组血浆PAI-1抗原和活性显著降低，而非训练组PAI-1水平保持不变。训练组93%（43条中的40条）的移植血管通畅，非训练组为76%（45条中的34条）（p<0.05）。血浆PAI-1高浓度可能会干扰自然溶栓过程。运动训练可降低ACBG术后PAI-1水平并增加TPA活性。运动训练带来的纤溶改善可能对移植血管通畅有有益影响。
