Brízida L, Mendes M, Adegas A, Seabra-Gomes R
Departamento de Reabilitação Cardíaca, Instituto do Coração, Carnaxide.
Rev Port Cardiol. 1996 Dec;15(12):877-83, 863-4.
To assess the effect of continuous and controlled exercise training on the lipid profile of coronary pts. in a cardiac rehabilitation program, we evaluated forty-nine males aged 56.8 +/- 9.6 years, thirty-two with previous surgical myocardial revascularization, two submitted to percutaneous transluminal coronary angioplasty and fifteen on exclusive pharmacological therapy. Patients with changes in drugs that could potentially induce modifications in serum lipid values, were excluded. The values of total cholesterol, triglycerides, HDL-cholesterol, the HDL-cholesterol/total cholesterol ratio, weight and the body mass index at admission of training phase, end of training phase (III)-21 patients (Group I) and maintenance (IV)-28 patients (Group II), were assessed. The training phase (III) had a duration of 3-4 months and maintenance (IV) nine months. In Group I, evaluated at the end of the training period (phase III), there was no significant modification in lipid profile reduction; only 1% and 20% reduction (p = NS) in values of total cholesterol and triglycerides, was detected. The HDL-cholesterol rose 12.5% (p = NS), and the HDL cholesterol/total cholesterol ratio 10.5% (p = NS). In Group II (at the end of the maintenance phase-IV-) there was no important change in total cholesterol levels. The HDL-cholesterol rose 19.5% (p = 0.003) and the HDL-cholesterol/total cholesterol ratio, also increased 33.3% (p < 0.0001). The benefit in relation to triglycerides was restricted to patients with higher values (> 200 mg/dl), where a reduction of 36% (p = 0.004) was found. There was no change in the weight or in body mass index, induced by the program. We concluded that the participation in a cardiac rehabilitation program induces a favourable modification of lipid profile in our population, with potential interest for secondary prevention of coronary heart disease. This change was particularly in serum values of triglycerides, HDL-cholesterol and the ratio HDL-cholesterol/total cholesterol. In what concerns triglycerides, the benefits were seen only in the group of patients with the highest serum values.
为评估在心脏康复项目中持续且有控制的运动训练对冠心病患者血脂水平的影响，我们对49名年龄在56.8±9.6岁的男性进行了评估，其中32例曾接受过外科心肌血运重建术，2例接受过经皮腔内冠状动脉成形术，15例仅接受药物治疗。排除了可能导致血清脂质值改变的药物变化的患者。评估了训练阶段入院时、训练阶段结束时（III期）的21例患者（I组）和维持阶段（IV期）的28例患者（II组）的总胆固醇、甘油三酯、高密度脂蛋白胆固醇、高密度脂蛋白胆固醇/总胆固醇比值、体重和体重指数的值。训练阶段（III期）持续3 - 4个月，维持阶段（IV期）持续9个月。在I组，在训练期结束时（III期）评估发现，血脂水平降低无显著变化；总胆固醇和甘油三酯值仅分别降低了1%和20%（p =无统计学意义）。高密度脂蛋白胆固醇升高了12.5%（p =无统计学意义），高密度脂蛋白胆固醇/总胆固醇比值升高了10.5%（p =无统计学意义）。在II组（维持阶段IV期结束时），总胆固醇水平无重要变化。高密度脂蛋白胆固醇升高了19.5%（p = 0.003），高密度脂蛋白胆固醇/总胆固醇比值也升高了33.3%（p < 0.0001）。甘油三酯方面的益处仅限于较高值（> 200 mg/dl）的患者，发现其降低了36%（p = 0.004）。该项目未引起体重或体重指数的变化。我们得出结论，参与心脏康复项目可使我们研究人群的血脂水平发生有利改变，对冠心病二级预防具有潜在意义。这种变化尤其体现在甘油三酯、高密度脂蛋白胆固醇以及高密度脂蛋白胆固醇/总胆固醇比值的血清值上。在甘油三酯方面，益处仅在血清值最高的患者组中可见。
