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在无脂肪体重正常的慢性阻塞性肺疾病(COPD)患者中,骨骼肌收缩力得以保留。

Skeletal muscle contractility is preserved in COPD patients with normal fat-free mass.

作者信息

Degens H, Sanchez Horneros J M, Heijdra Y F, Dekhuijzen P N R, Hopman M T E

机构信息

Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

出版信息

Acta Physiol Scand. 2005 Jul;184(3):235-42. doi: 10.1111/j.1365-201X.2005.01447.x.

Abstract

AIM

Peripheral muscle dysfunction often occurs in patients with chronic obstructive pulmonary disease (COPD). The muscle dysfunction may be caused by a loss of force-generating capacity, resulting from a loss of muscle mass, as well as by other alterations in contractile properties of skeletal muscle.

METHODS

The maximal isometric voluntary strength and fatigability were determined in hand-grip and quadriceps muscles from nine male COPD patients (FEV(1) 30-50% predicted) and control subjects matched for fat-free mass (FFM), physical activity level and age. Contractile properties and fatigability of the quadriceps muscle were also studied with electrically evoked isometric contractions.

RESULTS

The maximal voluntary force (MVC) and fatigability of the handgrip muscle did not differ between the COPD patients and control subjects. Also the MVC of the quadriceps muscle and the rate of force rise, contraction time, force-frequency relationship and fatigability, as determined with electrically evoked contractions, were similar in patients with COPD and control subjects.

CONCLUSION

Skeletal muscle strength, contractile properties and fatigability are preserved in patients with moderate COPD and a normal FFM and activity level. This suggests that skeletal muscle dysfunction does not take place during moderate COPD until cachexia and/or a decline in physical activity occur.

摘要

目的

慢性阻塞性肺疾病(COPD)患者常出现外周肌肉功能障碍。这种肌肉功能障碍可能是由于肌肉质量减少导致力量产生能力丧失,以及骨骼肌收缩特性的其他改变所致。

方法

测定了9名男性COPD患者(FEV(1)为预计值的30 - 50%)以及在无脂肪体重(FFM)、身体活动水平和年龄方面相匹配的对照受试者的握力和股四头肌的最大等长随意力量及疲劳性。还通过电诱发等长收缩研究了股四头肌的收缩特性和疲劳性。

结果

COPD患者和对照受试者之间握力肌肉的最大随意力量(MVC)和疲劳性没有差异。同样,COPD患者和对照受试者的股四头肌MVC以及通过电诱发收缩测定的力量上升速率、收缩时间、力量 - 频率关系和疲劳性也相似。

结论

中度COPD且FFM和活动水平正常的患者,其骨骼肌力量、收缩特性和疲劳性得以保留。这表明在中度COPD期间,直到恶病质和/或身体活动下降发生之前,骨骼肌功能障碍不会出现。

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