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作者：Jeong-Hun Shin 等 翻译：李常虹 发布者：翟佳羽 审校者：李常虹
目的： 人们已知类风湿关节炎与心血管疾病风险增加有关。本研究的目的在于评估太极锻炼对老年女性类风湿关节炎患者心血管疾病风险的影响。
方法： 总共56例女性类风湿关节炎患者纳入本项研究，其中29例患者接受每周一次的太极锻炼干预，共持续3个月，剩余的27例患者作为对照组仅接受锻炼对身体有益方面的常识教育。所有患者均在基线及3个月时评估类风湿关节炎疾病活动度、功能残疾（健康问卷评估）、心血管风险因素（血压、血脂、体重和吸烟）以及3项动脉粥样硬化评估指标（颈动脉内-中膜厚度、血流介导的内皮依赖性血管舒张功能和臂踝脉搏传导速度）。
结果： 血流介导的内皮依赖性血管舒张功能（FMD）是一种反映血管内皮细胞功能的指标，研究发现接受太极锻炼的类风湿关节炎患者较对照组FMD显著升高。此外，臂踝脉搏传导速度（baPWV）是一种反映动脉硬化程度的指标，试验发现接受太极锻炼的类风湿关节炎患者较对照组baPWV显著降低。在血脂方面，接受太极锻炼的类风湿关节炎患者总胆固醇水平较对照组显著下降，而其他与类风湿关节炎相关的特征方面，两组间没有明显差异。在排除总胆固醇水平影响之后，分析发现太极锻炼仍与血管内皮细胞功能和动脉僵硬度改善明显相关。
结论： 太极锻炼可改善老年女性类风湿关节炎患者的血管内皮功能紊乱和动脉僵硬程度，提示该锻炼方式可成为一种预防类风湿关节炎相关性心血管疾病风险的有效的行为疗法。
附原文： Background:Rheumatoid arthritis (RA) has been known to be associated with increased risk of cardiovascular disease (CVD). The aim of this study was to investigate the effects of Tai Chi exercise on CVD risk in elderly women with RA.Method:In total, 56 female patients with RA were assigned to either a Tai Chi exercise group (29 patients) receiving a 3-month exercise intervention once a week or a control group (27 patients) receiving general information about the benefits of exercise. All participants were assessed at baseline and at 3 months for RA disease activity (Disease Activity Score 28 and Routine Assessment of Patient Index Data 3), functional disability (Health Assessment Questionnaire), CVD risk factors (blood pressure, lipids profile, body composition, and smoking), and three atherosclerotic measurements: carotid intima-media thickness, flow-mediated dilatation (FMD), and brachial-ankle pulse wave velocity (baPWV).Results:FMD, representative of endothelial function, significantly increased in the Tai Chi exercise group (initial 5.85?±?2.05 versus 3 months 7.75?±?2.53 %) compared with the control group (initial 6.31?±?2.12 versus 3 months 5.78?±?2.13 %) (P?=?1.76?×?10?3). Moreover, baPWV, representative of arterial stiffness, significantly decreased in the Tai Chi exercise group (initial 1693.7?±?348.3 versus 3 months 1600.1?±?291.0 cm/s) compared with the control group (initial 1740.3?±?185.3 versus 3 months 1792.8?±?326.1 cm/s) (P?=?1.57?×?10?2). In addition, total cholesterol decreased significantly in the Tai Chi exercise group compared with the control group (?7.8?±?15.5 versus 2.9?±?12.2 mg/dl, P?=?2.72?×?10?2); other changes in RA-related characteristics were not significantly different between the two groups. Tai Chi exercise remained significantly associated with improved endothelial function (FMD; P?=?4.32?×?10?3) and arterial stiffness (baPWV; P?=?2.22?×?10?2) after adjustment for improvement in total cholesterol level.Conclusion:Tai Chi exercise improved endothelial dysfunction and arterial stiffness in elderly women with RA, suggesting that it can be a useful behavioral strategy for CVD prevention in patients with RA.
引自： Jeong-Hun Shin, Yonggu Lee, Soon Gil Kim, Bo Youl Choi, Hye-Soon Lee and So-Young Bang. The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis. Arthritis Research & Therapy, 2015, 17:380 DOI: 10.1186/s13075-015-0893-x.
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