方珍 朱益民 李静丹 吴丹红 林亚 饶玲艳 佘秋熳 陆明贝

[摘要] 目的 研究乳腺癌患者应用手机程序辅助式运动对血脂的效果。 方法 将2018年8月至2019年12月在本科室住院的148例乳腺癌患者按患者运动配合情况分为观察组62例和对照组86例。观察组患者进行中等强度有氧运动，采用运动打卡模式手机检控管理，对照组无运动干预。同时在术前、术后3个月、术后6个月、术后12个月抽静脉血进行检测总胆固醇（TC）、载脂蛋白B（Apo B）指标。对比两组患者的血脂代谢值。 结果 观察组与对照组的血TC值比较，差异有统计学意义（P<0.05）;不同运动时相的血TC值比较，差异有统计学意义（P<0.05）;随着运动时间的延长，血TC呈下降趋势，运动与不同时相之间存在着交互作用（P<0.05）。运动与非运动组间的血Apo B值相比，差异无统计学意义（P>0.05）;不同运动时相的血APO B值比较，差异有统计学意义（P<0.05）;随着运动时间的增加血APO B呈下降趋势，运动与不同时相之间存在着交互作用（P<0.05）。 结论 乳腺癌术后长期坚持有氧运动能有效降低术后TC，Apo B，从而降低广泛性动脉粥样硬化源性疾病（ASCVD）的危险因素。

[关键词] 乳腺癌;手机应用程序;辅助运动;血脂

[中图分类号] R737.9          [文献标识码] B          [文章编号] 1673-9701（2021）33-0085-03

[Abstract] Objective To study the effect of phone application-assisted exercise on blood lipid in patients with breast cancer. Methods A total of 148 patients with breast cancer hospitalized in our department from August 2018 to December 2019 were divided into the observation group （n=62） and the control group （n=86） according to exercise cooperation. Patients in the observation group underwent moderate-intensity aerobic exercise and were managed with mobile phone control using the exercise card playing mode. There was no exercise intervention in the control group. Venous blood samples were collected before the operation， 3 months， 6 months， and 12 months after the operation to detect total cholesterol（TC） and apolipoprotein B （ApoB）. Lipid metabolism values were compared between the two groups. Results There were significant differences in TC between the observation group and the control group （P<0.05）. Blood TC values differed during different phases of motion （P<0.05）. Blood TC showed a decreasing trend with increasing exercise time， and there was an interaction between exercise and different phases （P<0.05）. There was no significant difference in blood APOB values between the exercise and non-exercise groups（P>0.05）. There was a difference in blood APOB values at different exercise phases（P<0.05）. Blood APOB showed a downward trend with the increase of exercise time， and there was an interaction between exercise and different phases（P<0.05）. Conclusion Long-term aerobic exercise after breast cancer surgery can effectively reduce postoperative TC， ApoB， thereby reducing the risk factors of generalized atherosclerotic cardiovascular disease （ASCVD）.

[Key words] Breast Cancer; Mobile application; Assisted exercise; Lipid

乳腺癌已成女性惡性肿瘤之首，但随着乳腺癌早期诊断、手术和辅助治疗等综合治疗手段技术的发展，乳腺癌患者的生存率得到了显著提高[1]。高脂血症与乳腺癌复发转移和心脑血管疾病风险的相关性日益凸显，因此应重视乳腺癌患者全程的血脂管理[2]。依据《乳腺癌随访及伴随疾病全方位管理指南》，血脂检测应以术前水平作为基线标准[2]。既往调查发现，血脂异常控制率仅有4.0%，对于血脂异常危害的治疗率也较低[3]。乳腺癌术后重视合并症的管理和治疗，其中血脂异常发生率较高，需要长期管理[4]。临床上对高脂血症患者治疗时常建议患者进行有效的有氧运动，有数据表明其可以有效降低血清中TC浓度。本研究采取手机打卡干预措施提高乳腺癌患者术后运动时间，从而降低术后TC和Apo B的代谢，现报道如下。……