编者按：在之前的推文里，我们曾介绍了体育运动与颈动脉斑块关系的高水平证据（一项大型人群队列研究和一项临床干预试验），两者基本支持中等强度运动的有益作用。值得注意的是，大规模队列研究提示高强度运动可能增加易损斑新发风险。

“运动有益健康”仿佛已是真理般的常识，但随着研究的深入细化，研究者们逐渐意识到，运动产生的益处与运动形式、强度、频率有关，且随不不同人群变化（如年龄，性别等），需要根根不同的人群制定个性化的运动方案。

鉴于“有始有终”的原则，小编进行了一项非正式文献综述，帮助读者理解目前该领域的“基本共识”，总体来讲，目前相关研究表明，体育活动与颈动脉血管健康改善相关，但存在年龄、性别、种族差异等。详情如下：

01/研究问题：汇总目前关于体育运动与颈动脉粥样硬化的所有证据

02/研究方法：先手动检索核心文献，形成对本领域的初步见解，随后基于Elicit(类似于GPT的综述平台）完成综述，人工审核相关文献与结果

03/纳入研究基本特征：17项队列研究（包括前瞻性队列），17项横断面研究，2项随机对照试验，2项系统综述/荟萃分析，2项其他设计研究（前瞻性、横断面/干预结合）

04/相关证据总结

• 内中膜厚度（IMT）及相关指标：在25项研究中，增加体育活动、提高心肺适能或减少久坐行为均与IMT降低和IMT进展减慢相关。例如，一项试验中，高活动量参与者的平均IMT为0.12 mm，而低活动量者为0.20 mm；另一项研究显示，每增加1个代谢当量（MET）的心肺适能，IMT升高的几率降低10%。加速度计评估显示，活动强度增加可使IMT下降7–22 μm/年，而剂量-反应关系显示，剧烈活动可将IMT进展从14.3 μm/年降低至5.5 μm/年。

• 斑块及相关结局：8项研究总体显示体育活动有益，其中6项研究发现高活动量与斑块负荷降低、狭窄减轻或斑块特征更为有利相关。然而，有一项研究发现，高体育活动量与不稳定斑块特征相关（钙化和斑块内出血的比值比分别为2.69和1.93）。

• 影响因素：多项报告指出，体育活动的益处受年龄和性别影响。老年人轻度活动尤为重要，而年轻及中年人中，中等至高强度活动更具保护作用。

• 总结：总体来看，这些研究表明，体育活动与颈动脉血管健康改善相关，但存在年龄、性别、种族差异等。

  
  

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