| 摘要: | 隨著年齡漸長動脈老化及心血管事件在中年後也隨之增加。近年來高強度間歇運動被證實，是增加血管內皮功能，降低動脈硬化指數的有效運動處方。本研究探討結合心肺耐力測驗及高強度間歇踏步運動 (high–intensity interval step exercise, HIIT-S) 處方對於血管內皮功能及動脈硬化的影響。目的：瞭解給予連續五天的高強度間歇踏步運動處方作為健康中年女性日常替代運動的可行性及對血管內皮功能及動脈硬化之影響。方法：以 13 位健康中年女性 (49.5 ± 3.3 years) 為研究對象，實驗設計共分三週執行，第一週評估研究對象的踏步運動處方，第二週介入坐式休息作為控制組 (CON)，第三週介入連續五天的 HIIE-S 運動介入，檢測安靜值、運動後 30 分鐘及每天隔日 24 小時的肽激素 (adropin)、氮氧化物 (nitrite/nitrate, NOx) 作為觀察血管內皮功能的生化指標，而心踝血管指數 (cardio-ankle vascular index, CAVI) 及足踝上臂動脈血壓比 (ankle brachial pressure index, ABI) 作為評估動脈硬化及阻塞的指標。以重複量數單因子變異數分析介入 CON 的隔日及五天連續 HIIE-S 隔日與介入前的血管內皮與動脈硬化指數改變之差異情形，以重複量數二因子變異數分析考驗介入 CON 與 HIIE-S 的介入前至運動後 30 分鐘及運動後 30 分鐘至隔日的血管內皮與動脈硬化指數急性改變之差異情形。結果：一、所有研究對象在五天 HIIT-S 強度皆達 > 85% HRR 且每天的運動強度皆無顯著差異 (p > .05)。二、血管內皮功能 adropin 的血中濃度在 HIIE-S 介入後五天均上升，第一天隔日顯著上升優於第五天隔日 (677.1 ± 798.0 vs. 77.7 ± 1066.0 pg/ml, p < .05)、第四天隔日顯著上升優於與第五天隔日 (670.5 ± 586.2 vs. 77.7 ± 1066.0 pg/ml, p < .05)。三、動脈硬化指數：LCAVI 在 HIIE-S 介入後 30 分鐘顯著改善動脈硬化優於 CON 介入動脈硬化指數增加 (-.531 ± .647 vs. .092 ± .679, p < .05)。RABI 在 HIIE-S 介入後 30 分鐘顯著減少阻塞優於 CON 後增加阻塞 (.014 ± .079 vs. -.022 ± .083, p < .05)；連續五天 LABI 在第二天隔日阻塞顯著減少與 CON 隔日阻塞增加達顯著差異 (.042 ± .079 vs. -.036 ± .100, p < .01)。結論：HIIE-S 可作為健康中年女性高強度間歇替代運動類型。每週一天或連續四天 HIIE-S 運動介入對於改善血中 adropin 濃度效果最佳。HIIE-S 介入後可以改善動脈硬化及阻塞至運動後 30 分鐘，而坐式休息增加動脈硬化及阻塞，儘管在隔日會部分恢復，但仍無法回到安靜值水準。每週連續兩天 HIIE-S 運動對左側動脈阻塞指數 ABI 改善效果最佳。本研究結果建議對於健康中年女性可以利用 HIIE-S 作為改善內皮功能指標 adropin 及動脈硬化指數 CAVI、ABI 的運動訓練處方，可搭配定期評估動脈硬化指數了解血管健康改善狀態作為短期及長期運動介入修正之依據。
Increased arterial stiffness is observed with ageing and cardiovascular events gradually rising with middle-aged. Recently research showed, the high-intensity interval training prescription improved vascular endothelial function and decreased arterial stiffness index. This study investigated cardiorespiratory fitness testing and high–intensity interval step exercise (HIIE-S) on vascular endothelial function and arterial stiffness index benefits. Purpose: The effects of consecutive five-day per week HIIE-S prescription on vascular endothelial function and arterial stiffness index in middle-aged females. Methods: Thirteen subjects (49.5 ± 3.3 years) were recruited, first-week tested cardiorespiratory fitness and evaluated exercise’s BPM (beats per minute), second-week intervened 24-minute seated rest (CON) and third-week intervened HIIE-S. We were collected before and after 30-minute and 24-hr, included vascular endothelial function marker’s adropin, NOx and arterial stiffness index’s CAVI (cardio-ankle vascular index) and ABI (ankle-brachial pressure index). The data was analyzed with repeated measures one-way ANOVA compared different with intervened delta 24-hr CON and delta 24-hr five days exercise protocol, and repeated measures two-way ANOVA compared both groups intervened delta 30-minute and delta 30-minute to 24-hr marker and index. Results: 1. The HIIT-S intensity of all subjects reached > 85% HRR and there was no significant difference in five days exercise intensity (p > .05). 2. The vascular endothelial function marker: The adropin increased after HIIE-S intervention, and the delta 1-day, the delta 4-day were significantly higher than the delta 5-day (677.1 ± 798.0, 670.5 ± 586.2 vs. 77.7 ± 1066.0 pg/ml, p < .05). 3. Arterial stiffness index: LCAVI after HIIE-S intervened significant improve at delta 30 minutes better than CON increase index’s (-.531 ± .647 vs. .092 ± .679, p <.05). RABI after HIIE-S intervened significant improve at delta 30 minutes better than CON increased obstruction (.014 ± .079 vs. -.022 ± .083, p <.05). After serial 5-day HIIE-S intervened significant improve LABI on the delta 2-day was better than the delta CON increased obstruction (.042 ± .079 vs. -.036 ± .100, p <.01). Conclusions: HIIE-S can be used as a high-intensity alternative exercise type for healthy middle-aged females. One day per week or consecutive four days HIIE-S exercise intervened were the best for improving blood adropin concentration. After HIIE-S intervened can improve arterial stiffness and obstruction index to delta 30 minutes, but seated rest was observed increase arterial stiffness and obstruction index, although it will partially recover in the next day, but cannot return to the baseline level. The consecutive two days per week of HIIE-S exercise had the best effect on improving the LABI. The results of this study suggest that healthy middle-aged females can use HIIE-S exercise prescription as an improvement on vascular endothelial function mark's adropin and arterial stiffness index's CAVI, ABI. The future can be combine exercise with regular assessment of arterial stiffness index to understand the state of vascular health improvement as short-term and long-term exercise intervention basis for adjustment. |
