长期COVID和慢性疲劳综合征/肌痛性脑炎具有相似的运动限制病理生理机制
Swathi Jothi1, Michael Insel1, Guido Claessen2
1Division of Pulmonary, Critical Care, Sleep, and Allergy Medicine, University of Arizona, Tucson, Arizona, USA.
Physiological reports
|September 2, 2025
概括
后急性SARS-CoV-2 (PASC) 和慢性疲劳综合征/肌痛性脑炎 (CFS/ME) 的后果是运动不耐受. 骨肌肉的氧气扩散受损是这两种情况的关键限制因素,这表明它是潜在的治疗点.
科学领域:
- 心肺运动生理学
- 慢性疾病的病理生理学
- 呼吸系统和代谢医学
背景情况:
- SARS-CoV-2 后急性后果 (PASC) 和慢性疲劳综合征/肌痛性脑炎 (CFS/ME) 是复杂的疾病,经常出现重叠的症状,包括运动性呼吸障碍.
- 对于开发有效的治疗方法至关重要的是了解运动不耐受的潜在生理机制.
研究的目的:
- 通过运动氧气通路分析,研究PASC和CFS/ME中运动限制的共同机制.
- 确定这些患者群体中最受损害的氧气运输和利用的具体参数.
主要方法:
- 对15名PASC患者,11名CFS/ ME患者和11名健康对照患者进行了侵入性心肺运动测试.
- 运动氧气通路分析评估了六个参数:气泡通风 (V·a),肺扩散能力 (DL),心脏输出 (Q̇),骨肌肉扩散能力 (DM),血红蛋白 (Hb) 和线粒体氧化酸化 (Vmax).
- 每个参数都被顺序规范,以评估其对峰值氧气消耗的个人影响 (V·O2峰值).
主要成果:
- 与对照组相比,PASC和CFS/ ME组的峰值氧气消耗 (V̇O2峰值) 显著降低.
- 骨肌肉O2扩散 (DM) 在两组患者中出现最显著的受损参数 (p=0. 01).
- 单独对DM进行模拟的校正导致V̇O2显著改善 (66%在PASC中,p=0. 008;34. 7%在CFS/ ME中,p=0. 06),突出了其关键作用.
结论:
- 骨肌肉氧气扩散障碍 (DM) 是导致PASC和CFS/ME运动不耐受的主要共同机制.
- 针对外围氧气提取,特别是改善骨肌肉扩散能力,可能是这些衰弱性疾病的有希望的治疗策略.
- 需要使用更大的样本进行进一步的研究来证实这些发现并探索治疗干预措施.
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