Shiraishi Koichi, Motegi Shigeyuki, Nagaoka Reiko, Ogasawara Fusao, Saito Tetsuro, Watanabe Mitsuyuki, Matsuzaki Shohei
Department of Gastroenterology, Tokai University, Hachioji Hospital, Tokyo, Japan.
Alcohol Clin Exp Res. 2005 Dec;29(12 Suppl):282S-4S. doi: 10.1097/01.alc.0000191803.56958.d1.
The effects of chronic alcohol intake on skeletal muscle are clinically observed as muscle cramps with decrease in the amount of muscle. It was clarified by expired gas analysis that acute alcohol load affects disturbed energy metabolism of skeletal muscle. We studied abnormal energy metabolism of skeletal muscles in alcoholic liver diseases using expired gas analysis.
Subjects of the study were five inpatients with alcoholic liver disease (fatty liver: one case, hepatic fibrosis: one case, liver cirrhosis: three case). Expired gas analysis during exercise was performed using AEROMONITOR. Minute ventilation, oxygen consumption and carbon dioxide output were monitored, and anaerobic threshold (AT) and respiratory compensation point (RCP) were calculated.
The anaerobic threshold, which is the limit of the aerobic exercise, was significantly reduced in patients with alcoholic disease (p < 0.01). The respiratory compensation point, which is the limit of the metabolic compensation of intracellular lactic acidosis, was decreased (p < 0.01).
The results of expired gas analysis during exercise indicate that the aerobic energy metabolism of skeletal muscle had been disturbed in alcoholic liver disease. The reduced RCP suggests that the lactate metabolism in skeletal muscle is also disturbed in alcoholic liver disease. Expired gas analysis during exercise allows determination of the amount of exercise required to treat liver diseases through analysis of AT.
长期饮酒对骨骼肌的影响在临床上表现为肌肉痉挛以及肌肉量减少。通过呼出气体分析明确了急性酒精负荷会影响骨骼肌的能量代谢紊乱。我们使用呼出气体分析研究了酒精性肝病患者骨骼肌的能量代谢异常情况。
研究对象为5例酒精性肝病住院患者（脂肪肝：1例，肝纤维化：1例，肝硬化：3例）。使用AEROMONITOR进行运动期间的呼出气体分析。监测每分通气量、耗氧量和二氧化碳排出量，并计算无氧阈值（AT）和呼吸补偿点（RCP）。
酒精性疾病患者的无氧阈值（有氧运动的极限）显著降低（p < 0.01）。呼吸补偿点（细胞内乳酸酸中毒代谢补偿的极限）降低（p < 0.01）。
运动期间呼出气体分析结果表明，酒精性肝病患者骨骼肌的有氧能量代谢受到干扰。RCP降低表明酒精性肝病患者骨骼肌中的乳酸代谢也受到干扰。运动期间的呼出气体分析通过对AT的分析可以确定治疗肝病所需的运动量。
