慢性疾病中腿部氧气吸收峰值降低的生理决定因素:系统性审查和元分析
Stephen J Foulkes1,2,3, Peter D Wagner4, Jing Wang5
1Integrated Cardiovascular and Exercise Physiology and Rehabilitation (iCARE) Laboratory, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
患有COPD,HFrEF或RF等慢性疾病的患者由于氧气输送和肌肉氧气运输受损,运动能力降低. 外围因素对这种限制有显著的贡献,这表明了除了主要器官支持之外的新治疗点.
科学领域:
- 运动生理学 运动生理学
- 心肺生理学 心肺生理学
- 骨肌肉生理学 骨肌肉生理学
背景情况:
- 减少运动能力是慢性疾病的标志,影响生活质量和预后.
- 在慢性疾病中,限制峰值运动腿部氧气吸收 (V·o2) 的特定生理机制仍然不完全理解.
- 慢性阻塞性肺病 (COPD),心力衰竭与减少喷射率 (HFrEF) 和慢性功能衰竭 (RF) 与显著的运动不耐受性有关.
研究的目的:
- 在患有慢性疾病的患者中,系统地审查和元分析导致减少峰值运动腿V·o2的生理机制.
- 为了比较慢性疾病患者和健康对照者在大和小肌肉量运动期间的腿部氧气输送和肌肉氧气扩散导电.
- 确定慢性疾病 (如COPD,HFrEF和RF) 中运动限制的关键决定因素.
主要方法:
- 系统审查和对测量高峰腿V·o2及其生理决定因素的研究进行元分析.
- 包括涉及COPD,HFrEF或RF患者的研究和年龄匹配的对照.
- 使用加权平均差异 (WMD) 进行聚合分析,以比较循环和单腿膝盖延伸 (SLKE) 练习组之间的结果.
主要成果:
- 与对照组相比,患有慢性疾病的患者表现出明显较低的峰值腿V·o2 (WMD: -0.23 L/min).
- 在慢性疾病组中观察到腿部氧气输送受损 (WMD: -0.27 L/min) 和肌肉氧气扩散电导率 (WMD: -5.2 mL/min/mmHg).
- 这些限制存在于大型 (周期) 和小型肌肉质量 (SLKE) 运动期间.
结论:
- 减少COPD,HFrEF和RF的峰值运动腿Vo2是多因素的,涉及到受损的对流氧输送和减少肌肉氧气扩散运输.
- 外围因素,包括骨肌肉和血管系统,在运动限制中发挥着重要作用.
- 针对外围限制的治疗策略可以改善慢性疾病患者的运动能力,补充对主要器官功能障碍的治疗.
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