康复训练对高血压脑卒中病人血浆TWEAK表达的影响
Effect of rehabilitation training on plasma TWEAK level in hypertensive stroke patients, and its predictive value in heart and lung functions
-
摘要: 目的：探讨康复训练对高血压脑卒中病人肿瘤坏死因子样弱凋亡诱导因子（TWEAK）水平的影响。方法：选取高血压脑卒中病人82例随机分为对照组和观察组，各41例。对照组采取常规治疗，观察组于对照组基础上，采用康复训练。采用酶联免疫吸附法测定研究对象在治疗前后的血浆TWEAK的变化，采用纽约心功能分级和综合心肺功能测试系统评价病人的心肺功能。结果：治疗前2组TWEAK水平比较差异无统计学意义（P>0.01），治疗后2组TWEAK水平均较治疗前显著降低（P<0.01），且观察组显著低于对照组（P<0.01）。治疗后观察组肺功能指标用力肺活量（FVC）、第一秒用力呼气量占FVC百分率（FEV1/FVC）、最大通气量（MVV）、最大呼气中期流量（MMEF）均较治疗前显著增加，功能残气量（RV）和残气量/肺总量（RV/TLC）均显著降低（P<0.01），对照组MMEF较治疗前显著增加，RV/TLC显著降低（P<0.01），且观察组FVC、FEV1/FVC、MVV、MMEF指标显著高于对照组，RV和RV/TLC指标显著低于对照组（P<0.01）。治疗后2组心功能分级比较差异有统计学意义（P<0.05）。TWEAK分别与FVC、FEV1/FVC、MVV、MMEF、RV、RV/TLC以及NYHA存在一定的相关性（P<0.05~P<0.01）。结论：康复训练能够有效降低高血压脑卒中病人TWEAK水平。TWEAK和纽约心功能分级等心肺功能评价指标存在一定的相关性，可以作为预测病人心肺功能的指标。
-
关键词:
- 脑卒中 /
- 人肿瘤坏死因子样弱凋亡诱导因子 /
- 高血压 /
- 心肺功能
Abstract: Objective:To investigate the effects of rehabilitation training on plasma tumor necrosis factor-like weak inducer of apoptosis(TWEAK) level in hypertensive stroke patients,and its predictive value in heart and lung functions.Methods:Eighty-two patients with hypertensive stroke were randomly divided into the control group and observation group(41 cases each group).The control group were treated with conventional therapy,and the observation group were additionally treated with rehabilitation training based on the control group.The plasma levels of TWEAK in two groups before and after treatment were detected using the enzyme-linked immunosorbent assay,and the heart and lung functions in two groups were evaluated using the NYHA functional test system and integrated cardiopulmonary evaluation system.Results:The difference of the level of TWEAK between two groups before treatment was not statistically significant(P>0.05),the levels of TWEAK in two groups significantly decreased after treatment(P<0.01),and which in observation group was significantly lower than that in control group(P<0.01).Compared before treatment,the FVC,FEV1,FEV1/FVC,MVV and MMEF in observation group significantly increased after treatment,and the RV,RV/TLC in observation group significantly decreased after treatment(P<0.01).Compared with before treatment,the MMEF in control group significantly increased,and the PV/TLC in control group significantly increased after treatment(P<0.01).After treatment,the levels of FVC,FEV1/FVC,MVV and MMEF in observation group were significantly higher than those in control group,and the levels of RV and RV/TLC in observation group were significantly lower than those in control group(P<0.01).After treatment,the difference of the cardiac functional grading between two groups after treatment was statistically significant(P<0.05).The TWEAK was correlation with FVC,FEV1/FVC,MVV,MMEF,RV,RV/TLC and NYHA(P<0.05 to P<0.01).Conclusions:The rehabilitation training can effectively reduce the plasma levels of TWEAK in hypertensive stroke patients.The plasma TWEAK is related to the NYHA cardiopulmonary function evaluation,which can be used as the predictor of the heart and lung function. -
[1] ILTER A,OREM C,YUCESAN FB,et al.Evaluation of serum sTWEAK and sCD163 levels in patients with acute and chronic coronary artery disease[J].Int J Clin Exp Med,2015,8(6):9394. [2] DOMBROWSKI SU,FORD GA,MORGENSTERN LB,et al.Differences between US and UK adults in stroke preparedness:evidence from parallel population-based community surveys[J].Stroke,2015,46(11):3220. [3] TSIVGOULIS G,PSALTOPOULOU T,WADLEY VG,et al.Wadley,adherence to a Mediterranean diet and prediction of incident stroke[J].Stroke,2015,46(3):780. [4] LANSBERG MG,O'DONNELL MJ,KHATRI P,et al.Antithrombotic and thrombolytic therapy for ischemic stroke:Antithrombotic Therapy and Prevention of Thrombosis,9th ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J].Chest,2012,141(Suppl 2):e601S. [5] MESCHIA JF,BUSHNELL C,BODEN-ALBALA B,et al.Guidelines for the primary prevention of stroke:a statement for healthcare professionals from the American Heart Association/American Stroke Association[J].Stroke,2014,45(12):3754. [6] HOWARD G,BANACH M,CUSHMAN M,et al.Is blood pressure control for stroke prevention the correct goal? The lost opportunity of preventing hypertension[J].Stroke,2015,46(6):1595. [7] HOWARD VJ,WOOLSON RF,EGAN BM,et al.Prevalence of hypertension by duration and age at exposure to the stroke belt[J].J Am Soc Hypertens,2010,4(1):32. [8] HOWARD VJ,TANNER RM,ANDERSON A,et al.Apparent treatment-resistant hypertension among individuals with history of stroke or transient ischemic attack[J].Am J Med,2015,128(7):707. [9] IRVIN MR,BOOTH JN 3rd,SHIMBO D,et al.Apparent treatment-resistant hypertension and risk for stroke,coronary heart disease,and all-cause mortality[J].J Am Soc Hypertens,2014,8(6):405. [10] WILLEY JZ,BOEHME AK,CASTAGNA F,et al.Hypertension and stroke in patients with left ventricular assist devices(LVADS)[J].Curr Hypertens Rep,2016,18(2):12. -
点击查看大图
计量
- 文章访问数: 3559
- HTML全文浏览量: 412
- PDF下载量: 55
- 被引次数: 0
下载:
