Gardner A W, Killewich L A, Katzel L I, Womack C J, Montgomery P S, Otis R B, Fonong T
Claude D. Pepper Older Americans Independence Center, Department of Medicine, University of Maryland, Baltimore, USA.
Angiology. 1999 Apr;50(4):289-97. doi: 10.1177/000331979905000404.
The purpose of this study was to determine the relationship between free-living daily physical activity and peripheral circulation under resting, reactive hyperemia, and maximal exercise conditions in peripheral arterial occlusive disease (PAOD) patients with intermittent claudication. Sixty-one PAOD patients (age = 70 +/- 6 years, ankle/brachial index [ABI] = 0.57 +/- 0.24) were recruited from the Vascular Clinic at the Baltimore Veterans Affairs Medical Center and from radio and newspaper advertisements. Free-living daily physical activity was measured as the energy expenditure of physical activity (EEPA), determined from doubly labeled water and indirect calorimetry. Patients also were characterized on ankle/brachial index, calf blood flow, calf transcutaneous oxygen tension (TcPO2), and calf transcutaneous heating power (TcHP). ABI and calf blood flow served as markers of the macrocirculation of the lower extremity, while TcPO2 and TcHP served as markers of the microcirculation. The claudication patients were sedentary, reflected by a mean EEPA value of 486 +/- 274 kcal/day. EEPA was related to calf TcHP at rest (282 +/- 24 mW; r = -0.413, p = 0.002), after postocclusion reactive hyperemia (275 +/- 22 mW; r = -0.381, p = 0.004), and after maximal exercise (276 +/- 20 mW; r = -0.461, p<0.001). ABI, calf blood flow, and calf TcPO2 were not related to EEPA under any condition. In conclusion, higher levels of free-living daily physical activity were associated with better microcirculation of the calf musculature in older PAOD patients with intermittent claudication.
本研究的目的是确定间歇性跛行的外周动脉闭塞性疾病（PAOD）患者在静息、反应性充血和最大运动条件下，日常自由生活中的身体活动与外周循环之间的关系。从巴尔的摩退伍军人事务医疗中心的血管诊所以及电台和报纸广告中招募了61名PAOD患者（年龄 = 70±6岁，踝臂指数[ABI] = 0.57±0.24）。日常自由生活中的身体活动通过身体活动能量消耗（EEPA）来衡量，该能量消耗由双标水和间接量热法测定。患者还通过踝臂指数、小腿血流量、小腿经皮氧分压（TcPO2）和小腿经皮加热功率（TcHP）进行特征描述。ABI和小腿血流量作为下肢大循环的标志物，而TcPO2和TcHP作为微循环的标志物。跛行患者久坐不动，平均EEPA值为486±274千卡/天，这反映了这一点。静息时（282±24毫瓦；r = -0.413，p = 0.002）、闭塞后反应性充血后（275±22毫瓦；r = -0.381，p = 0.004）以及最大运动后（276±20毫瓦；r = -0.461，p<0.001），EEPA与小腿TcHP相关。在任何情况下，ABI、小腿血流量和小腿TcPO2均与EEPA无关。总之，在患有间歇性跛行的老年PAOD患者中，较高水平的日常自由生活身体活动与小腿肌肉组织更好的微循环相关。
