带有或没有监督运动的粒细胞巨殖民地刺激因子对患有外周动脉疾病的患者的行走表现的影响:PROPEL随机临床试验
Mary M McDermott1,2, Luigi Ferrucci3, Lu Tian4
1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA
|November 16, 2017
概括
在外围动脉疾病 (PAD) 患者中,受监督的跑步机运动显著改善了步行距离. 当单独使用或与运动一起使用时,花细胞巨细胞殖民地刺激因子 (GM-CSF) 没有增强这些益处.
科学领域:
- 心血管医学
- 复原医学
- 临床试验
背景情况:
- 周围动脉疾病 (PAD) 损害了行走能力,而颗粒细胞巨细胞殖民地刺激因子 (GM-CSF) 在改善这种状况中的作用尚不清楚.
- 步行运动可以通过促进前代细胞释放和指向缺血肌肉来增强PAD的GM-CSF效应.
研究的目的:
- 评估GM-CSF与监督的跑步机运动相结合是否能改善与单独运动或GM-CSF相比的6分钟步行距离.
- 为了确定GM-CSF是否比安慰剂更能改善6分钟的步行距离.
- 评估运动是否比注意力控制干预更能改善6分钟的步行距离.
主要方法:
- 一个随机临床试验,采用2x2因子设计,涉及210名患有PAD的参与者.
- 参与者被分配到四个组之一:运动+GM-CSF,单独运动,单独GM-CSF,或注意力控制+安慰剂.
- 干预包括6个月的监督跑步机炼或教育讲座,用GM-CSF或安慰剂进行皮下注射.
主要成果:
- 与注意力对照组相比,受监督的跑步机运动显著改善了6分钟的步行距离 (平均差异为+33. 6米;P=. 02).
- 与安慰剂或单独运动相比,GM-CSF单独或与运动相结合并没有显著改善6分钟的步行距离.
- 与单独运动相比,运动+GM-CSF没有显著改善 (平均差异为- 6. 3米;P=.61).
结论:
- 被监督的跑步机运动有效地改善了PAD患者的步行表现.
- 在单独使用或与运动一起使用时,GM-CSF似乎对PAD的行走障碍没有额外的益处.
- 这些发现支持运动作为PAD相关走路困难的主要治疗方式,但不支持使用GM-CSF.
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