外周动脉疾病患者对上下肢有氧运动的相对耐受性

Relative tolerance to upper- and lower-limb aerobic exercise in patients with peripheral arterial disease.

作者信息

Zwierska I, Walker R D, Choksy S A, Male J S, Pockley A G, Saxton J M

机构信息

The Centre for Sport and Exercise Science, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield S10 2BP, UK.

出版信息

Eur J Vasc Endovasc Surg. 2006 Feb;31(2):157-63. doi: 10.1016/j.ejvs.2005.06.025. Epub 2005 Aug 10.

DOI:10.1016/j.ejvs.2005.06.025

PMID:16095931

Abstract

OBJECTIVES

To investigate the effects of peripheral arterial disease (PAD) on relative tolerance to upper- and lower-limb aerobic exercise.

METHODS

Peak cardiorespiratory responses evoked by an incremental arm-cranking test (ACT) and an incremental leg-cranking test (LCT) were compared in patients with PAD (N=101; median age 69 year, range 50-85 years). Claudication distance (CD) and total distance before intolerable claudication pain (maximum walking distance: MWD) were also assessed during walking.

RESULTS

Peak oxygen consumption (V O(2)) for the ACT was 94% of that measured for the LCT (1.01+/-0.03 versus 1.10+/-0.03lmin(-1), respectively; P<0.001), but in a significant proportion of patients (35%; P<0.001), exceeded that recorded for the LCT. The ratio of upper- to lower-limb peak V O(2) was higher (0.98+/-0.04 compared to 0.98+/-0.05lmin(-1) and 1.00+/-0.06 compared to 1.21+/-0.06lmin(-1); P<0.01), whereas walking performance (CD: 94+/-14 versus 187+/-25 m, P<0.01; MWD: 227+/-20 versus 394+/-33 m, P<0.01) was lower for patients in the lowest ankle to brachial pressure index quartile compared to patients in the highest quartile, respectively.

CONCLUSION

Upper-limb aerobic conditioning could be a useful exercise stimulus for maintaining or improving cardiorespiratory function in patients with severe PAD as they have a greater relative upper-limb aerobic power.

摘要

目的

研究外周动脉疾病（PAD）对上下肢有氧运动相对耐受性的影响。

方法

比较了PAD患者（N = 101；中位年龄69岁，范围50 - 85岁）在递增式手臂曲柄试验（ACT）和递增式腿部曲柄试验（LCT）中诱发的心肺峰值反应。还在步行过程中评估了跛行距离（CD）和出现无法忍受的跛行疼痛前的总距离（最大步行距离：MWD）。

结果

ACT的峰值耗氧量（V O₂）为LCT测量值的94%（分别为1.01±0.03与1.10±0.03 lmin⁻¹；P < 0.001），但在相当比例的患者中（35%；P < 0.001），ACT的峰值耗氧量超过了LCT记录的值。上下肢峰值V O₂的比值更高（分别为0.98±0.04与0.98±0.05 lmin⁻¹以及1.00±0.06与1.21±0.06 lmin⁻¹；P < 0.01），而与最高四分位数的患者相比，最低踝臂压力指数四分位数的患者步行表现（CD：94±14与187±25 m，P < 0.01；MWD：227±20与394±33 m，P < 0.01）更低。