Effects of aerobic exercise combined with Levocarnitine on improving endothelial function and antioxidation in patients with stable angina pectoris of coronary heart disease

中国综合临床 Pub Date : 2019-11-01 DOI:10.3760/CMA.J.ISSN.1008-6315.2019.06.009

Li Yang, Guojun Wang, Yan Gao, Rong Jing, Kun Huang

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Abstract

Objective To investigate the effect of aerobic exercise combined with Levocarnitine in treating stable angina pectoris(SAP) and its effect on vascular endothelial function and serum levels of superoxide dismutase(SOD), total antioxidant capacity(TAC), glutathione peroxidase(GSH-px), malondialdehyde (MDA), and lipid peroxide(LPO). Methods One hundred and fifty patients with SAP were selected in Affiliated Hospital of Yan′an University from september 2017 to september 2018 and randomly divided into control group and observation group(75 cases in each group). Both groups received routine intervention according to the guidelines.The control group was given with intravenous drip of left carnitine(3 g/time and once a day). On basis of the control group, the observation group was treated with regular aerobic exercise therapy.After 8 weeks' treatment for two groups, attack frequency degree of angina pectoris, score of life quality of Seattle angina scale(SAQ), and clinical effect were compared between the two groups.And the vascular endothelial function(plasma endothelin(ET)1, nitric oxide(NO)), flow mediated vasodilation(FMD) of brachial artery and antioxidant effect(serum levels of SOD, TAC, GSH-px, MDA and LPO) were detected. Results After 8 weeks' treatment, frequency of angina pectoris and episode of duration of angina pectoris in the observation group were less((4.19±0.56) vs.(6.22±0.89) time, (4.31±0.50) vs.(5.25±0.71) min), while life quality indexes SAQ score was higher, than those in the control group, and the difference was statistically significant((18.44±2.30) vs.(12.49±1.82) score, (56.31±6.62) vs.(48.05±5.88) score, (14.46±1.99) vs.(9.22±1.10) score, (21.41±2.95))vs.(18.09±2.26) score, (16.14±2.17) vs.(12.05±1.82) score, (all P<0.01)). The total clinical effective rate of the observation group (92% (69 / 75)) was higher than that of the control group (80% (60 / 75)), the difference was statistically significant (χ2=4.485, P=0.034). After 8 weeks′ treatment, level of ET-1, FMD of brachial artery, MDA, and LPO were lower than those in the control group((65.38±7.91) ng/L vs.(77.12±8.56) ng/L, (9.44±1.34)% vs.(12.55±1.81)%, (2.81±0.43) μmol/L vs.(3.90±0.50) μmol/L, (3.14±0.44) μmol/L vs.(4.40±0.63) μmol/L), while NO, SOD, TAC, GSH-px were higher than control group((67.51±7.79) μmol/L vs.(52.17±6.08) μmol/L, (85.25±9.67)U/L vs.(76.01±8.33) U/L, (12.79±1.80) kU/L vs.(9.64±11.05) kU/L, (117.65±15.03) U/L vs.(111.76±14.19) U/L), and the difference was statistically significant (all P<0.01). Conclusion Aerobic exercise combined with Levocarnitine in treating SAP can reduce the attack of angina pectoris, improve the life treatment of patients, and improve the clinical effect, which may be related to the improvement of endothelial function and antioxidant effect. Key words: Aerobic exercise; Levocarnitine; Stable angina pectoris; Vascular endothelial function; Antioxidant

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有氧运动联合左卡尼汀对冠心病稳定型心绞痛患者内皮功能及抗氧化的影响

目的探讨有氧运动联合左旋卡尼汀治疗稳定型心绞痛（SAP）的疗效及其对血管内皮功能和血清超氧化物歧化酶（SOD）、总抗氧化能力（TAC）、谷胱甘肽过氧化物酶（GSH-px）、丙二醛（MDA）和过氧化脂质（LPO）水平的影响。方法选择延安大学附属医院2017年9月至2018年9月收治的150例SAP患者，随机分为对照组和观察组（每组75例）。两组均按照指导原则接受了常规干预。对照组静脉滴注左旋肉碱（3g/次，每天一次）。在对照组的基础上，观察组采用常规有氧运动疗法。两组治疗8周后，比较两组心绞痛发作频率、西雅图心绞痛生活质量量表（SAQ）评分及临床疗效。检测血管内皮功能（血浆内皮素（ET）1、一氧化氮（NO））、肱动脉血流介导的血管舒张（FMD）和抗氧化作用（血清SOD、TAC、GSH-px、MDA和LPO水平）。结果治疗8周后，观察组心绞痛发作次数和持续时间较对照组减少（（4.19±0.56）vs.（6.22±0.89）次，（4.31±0.50）vs，（56.31±6.62）对（48.05±5.88）分，（14.46±1.99）对（9.22±1.10）分，ET-1、肱动脉FMD、MDA和LPO水平低于对照组（（65.38±7.91）ng/L vs.（77.12±8.56）ng/L，（9.44±1.34）%vs.（12.55±1.81）%，（2.81±0.43）μmol/L vs.（3.90±0.50）μmol/L，（3.14±0.44）μmol/L vs（4.40±0.63）μmol/L），NO、SOD、TAC、GSH-px高于对照组（67.51±7.79）μmol/L vs（52.17±6.08）μmol/L，（85.25±9.67）U/L与（76.01±8.33）U/L、（12.79±1.80）kU/L与[9.64±11.05]kU/L、[117.65±15.03]U/L与]111.76±14.19）U/L，差异有统计学意义（均P<0.01），这可能与改善内皮功能和抗氧化作用有关。关键词：有氧运动；左旋卡尼汀；稳定型心绞痛；血管内皮功能；抗氧化剂

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来源期刊

中国综合临床

CiteScore

0.10

自引率

0.00%

发文量

16855

期刊介绍： Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.