关键词: 卒中, 颈动脉, 血管功能, 太极拳, 运动疗法, 治疗结果

Abstract: Objective　To explore influence of Tai Chi training on carotid artery function in community-dwelling populations at high risk of ischemic stroke.Methods　From October 2014 to March 2015，we recruited 170 eligible individuals at high risk of ischemic stroke from 3 communities located on Huada Street，Fuzhou's Gulou District and equally randomized them into the control group and Tai Chi training group.The participants in the Tai Chi training group received a 12-week Tai Chi training（five times per week，60 minutes each time），while those in the control group maintained their lifestyle without additional physical activities.The outcome indicators including carotid intima-media thickness（CIMT），blood flow velocity of carotid sinus，resistance index of carotid artery and carotid plaque measured by transcranial Doppler were compared at baseline，at the end of 12-week intervention period，and end of additional 12-week follow-up period.Results　Mixed linear model analysis showed the following：the main effects produced by intervention content were significant on left CIMT（P<0.05），but were insignificant and similar on right CIMT，blood flow velocities of left and right carotid sinus，resistance indices in the left and right internal carotid arteries（P>0.05）．The main effects exerted by intervention duration were obvious on left and right CIMT，resistance indices in the left and right internal carotid arteries（P<0.05），but were insignificant and similar on blood flow velocities of left and right carotid sinus（P>0.05）．Intervention content and duration had no interactive effects on all the outcome indicators（P>0.05）．Furthermore, left CIMT became similar in both groups after intervention and after follow-up（P>0.10） although it was greater in the Tai Chi training group before intervention found by the t-test run with an α level of 0.10（P=0.06）; the resistance index in the left internal carotid artery was significantly decreased in the Tai Chi training group after intervention（P<0.05） although it was similar in both groups before intervention and after follow-up（P>0.05）. The analysis with generalized estimating equation found that the mean prevalence of carotid plaque was lower in Tai Chi training group rather than control group（P<0.05）；the prevalence of carotid plaque in both groups did not receive any significant main effects produced by intervention duration as well as significant interactive effects between intervention content and duration（P>0.05）．Conclusion　A 12-week Tai Chi training was beneficial to block the increase of CIMT，reduce the resistance index of carotid artery and formation of carotid plaque in community-dwelling populations at high risk for ischemic stroke.It may be an effective exercise intervention to prevent ischemic stroke.

Key words: Stroke, Carotid artery, Vascular function, Tai Chi, Exercise therapy, Treatment outcome