危险因素管理在心脏康复中的作用
摘要
随着心脏康复的不断开展,越来越多的研究发现,心脏康复可以减少心血管病对患者生理和心理的影响,稳定甚至逆转动脉粥样硬化(AS)的进程,减轻相关症状,增强患者的心理、社会和职业适应能力,降低再发心肌梗死和猝死的风险。近年的临床研究结果表明,心脏康复不应局限于心血管病本身,而应拓展至二级预防,甚至一级预防。在进行心脏康复的同时,进一步控制好影响心血管病患者预后的危险因素,可以大大提高心脏康复的疗效。本文就控制吸烟、高血压、肥胖、高脂血症和糖尿病这5个常见心血管危险因素管理在心脏康复中的意义作一综述。
引文
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[25]Dobbins RL,Szczepaniak LS,Bentley B,et al.Prolonged inhibition of muscle carnitine palmitoyltransferase-1 promotes intramyocellular lipid accumulation and insulin resistance in rats[J].Diabetes,2001,50(1)∶123-130.DOI∶10.2337/diabetes.50.1.123.
[2]De Schutter A,Kachur S,Lavie CJ,et al.Cardiac Rehabilitation Fitness Changes and Subsequent Survival[J].Eur Heart J Qual Care Clin Outcomes,2018,4(3)∶173-179.DOI∶10.1093/ehjqcco/qcy018.
[3]Katzenberg C,Silva E,Young MJ,et al.Outcomes in a Community-Based Intensive Cardiac Rehabilitation Program[J].Am J Med,2018,131(8)∶967-971.DOI∶10.1016/j.amjmed.2018.03.029.
[4]蒋承建,潘孙雷,池菊芳,等.不同心脏康复模式在急性心肌梗死经皮冠状动脉介入治疗术后早期的临床价值研究[J].中国全科医学,2017,20(20)∶2439-2445.DOI∶10.3969/j.issn.1007-9572.2017.20.003.
[5]Bhardwaj M,Price J,Landry M,et al.Association Between Severity of Depression and Cardiac Risk Factors Among Women Referred to a Cardiac Rehabilitation and Prevention Clinic[J].J Cardiopulm Rehabil Prev,2018,38(5)∶291-296.DOI∶10.1097/hcr.0000000000000311.
[6]郭建君,郭航远,池菊芳,等.吸烟对心血管病的影响及最新进展[J].中国全科医学,2017,20(27)∶3328-3331.DOI∶10.3969/j.issn.1007-9572.2017.00.034.
[7]Ockene JK,Kuller LH,Svendsen KH,et al.The relationship of smoking cessation to coronary heart disease and lung cancer in the Multiple Risk Factor Intervention Trial(MRFIT)[J].Am J Public Health,1990,80(8)∶954-958.DOI∶10.2105/ajph.80.8.954.
[8]Zevin S,Saunders S,Gourlay SG,et al.Cardiovascular effects of carbon monoxide and cigarette smoking[J].J Am Coll Cardiol,2001,38(6)∶1633-1638.DOI∶10.1016/s0735-1097(01)01616-3.
[9]Ambrose JA,Barua RS.The pathophysiology of cigarette smoking and cardiovascular disease:an update[J].J Am Coll Cardiol,2004,43(10)∶1731-1737.DOI∶10.1016/j.jacc.2003.12.047.
[10]杨芳芳,郭航远.心脏康复五大处方之戒烟处方[J].中华内科杂志,2014,53(11)∶903-905.DOI∶10.3760/cma.j.issn.0578-1426.2014.11.017.
[11]郭航远,唐伟良,邢杨波.中国高血压的“四高四低”特点分析[J].中国全科医学,2012,15(2)∶114-116.DOI∶10.3969/j.issn.1007-9572.2012.02.002.
[12]Petrella RJ.How effective is exercise training for the treatment of hypertension[J].Clin J Sport Med,1998,8(3)∶224-231.DOI∶10.1097/00042752-199904000-00016.
[13]Sakai T,Ideishi M,Miura S,et al.Mild exercise activates renal dopamine system in mild hypertensives[J].J Hum Hypertens,1998,12(6)∶355-362.DOI∶10.1038/sj.jhh.1000608.
[14]葛万刚,孙兴国,刘艳玲,等.心肺运动试验精准制定个体化适度强度运动康复处方治疗高血压的疗效研究[J].中国全科医学,2016,19(35)∶4316-4322.DOI∶10.3969/j.issn.1007-9572.2016.35.006.
[15]Kalladka M,Greenberg BL,Padmashree SM,et al.Screening for coronary heart disease and diabetes risk in a dental setting[J].Int J Public Health,2014,59(3)∶485-492.DOI∶10.1007/s00038-013-0530-x.
[16]Jia G,Demarco VG,Sowers JR.Insulin resistance and hyperinsulinaemia in diabetic cardiomyopathy[J].Nat Rev Endocrinol,2016,12(3)∶144-153.DOI∶10.1038/nrendo.2015.216.
[17]Fedewa MV,Gist NH,Evans EM,et al.Exercise and insulin resistance in youth∶a meta-analysis[J].Pediatrics,2014,133(1)∶e163-174.DOI∶10.1542/peds.2013-2718.
[18]Trends in adult body-mass index in 200 countries from 1975 to2014∶a pooled analysis of 1698 population-based measurement studies with 19.2 million participants[J].Lancet,2016,387(10026)∶1377-1396.DOI∶10.1016/s0140-6736(16)30054-x.
[19]雷洪强,徐琳,邱健,等.心血管病患者心脏康复前后腰围与器官损害的相关性[J].南方医科大学学报,2016,36(1)∶83-89.DOI∶10.3969/j.issn.1673-4254.2016.01.15.
[20]Turkbey EB,Mcclelland RL,Kronmal RA,et al.The impact of obesity on the left ventricle∶the Multi-Ethnic Study of Atherosclerosis(MESA)[J].JACC Cardiovasc Imaging,2010,3(3)∶266-274.DOI∶10.1016/j.jcmg.2009.10.012.
[21]Viswanathan K,Hall AS,Barth JH.An evidence-based approach to the assessment of heart-type Fatty Acid binding protein in acute coronary syndrome[J].Clin Biochem Rev,2012,33(1)∶3-11.DOI∶10.2337/diabetes.50.1.123.
[22]Castelli WP.Epidemiology of coronary heart disease:the Framingham study[J].Am J Med,1984,76(2a)∶4-12.DOI∶10.1016/0002-9343(84)90952-5.
[23]Larosa JC,Hunninghake D,Bush D,et al.The cholesterol facts.Asummary of the evidence relating dietary fats,serum cholesterol,and coronary heart disease.A joint statement by the American Heart Association and the National Heart,Lung,and Blood Institute.The Task Force on Cholesterol Issues,American Heart Association[J].Circulation,1990,81(5)∶1721-1733.DOI∶10.1161/01.CIR.81.5.1721.
[24]Li B,Zerby HN,Lee K.Heart fatty acid binding protein is upregulated during porcine adipocyte development[J].J Anim Sci,2007,85(7)∶1651-1659.DOI∶10.2527/jas.2006-755.
[25]Dobbins RL,Szczepaniak LS,Bentley B,et al.Prolonged inhibition of muscle carnitine palmitoyltransferase-1 promotes intramyocellular lipid accumulation and insulin resistance in rats[J].Diabetes,2001,50(1)∶123-130.DOI∶10.2337/diabetes.50.1.123.