Canavan Jane, Garrod Rachel, Marshall Johanna, Jackson David, Ansley Paula, Jewell Andy
School of Physiotherapy, Faculty of Health and Social Care Sciences, St. George's, University of London, London, United Kingdom.
Int J Chron Obstruct Pulmon Dis. 2007;2(3):347-53.
This pilot study concerns the evaluation of the acute cytokine response to exercise and changes in this throughout a 7 week pulmonary rehabilitation programme.
17 (10 male, 7 female) stable COPD patients, mean (SD) age 69 (8) yrs, mean FEV1, 51.3 (17.3)% predicted entered into 7 weeks of rehabilitation. The acute cytokine response (ACR) was measured from serum cytokine levels; Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and C-reactive protein (CRP) taken pre, post and 1 hour post-maximal incremental shuttle walking test (ISWT). The ACR to maximal exercise was determined before rehabilitation (TO) and post rehabilitation (T7). The ACR (pre/post test) to iso-distance exercise (based on initial ISWT distance) was determined throughout the rehabilitation period at 2 (T2), 4 (T4) weeks and at the end (T7).
12 patients completed the study. Maximal ISWT distance significantly increased after rehabilitation. There was no significant change in baseline cytokine level throughout; or in pre/post-exercise cytokine levels prior to, during or following rehabilitation.
There was no significant inflammatory response associated with maximal exercise before or after training. Cytokine responses to a fixed bout of exercise did not alter markedly throughout. Clinical PR is unlikely to exacerbate systemic inflammation in COPD.
本初步研究旨在评估运动引起的急性细胞因子反应，以及在为期7周的肺康复计划中该反应的变化情况。
17名（10名男性，7名女性）稳定期慢性阻塞性肺疾病（COPD）患者，平均（标准差）年龄69（8）岁，平均第一秒用力呼气容积（FEV1）为预计值的51.3（17.3）%，参加了为期7周的康复训练。通过检测血清细胞因子水平来测量急性细胞因子反应（ACR）；在最大递增往返步行试验（ISWT）前、后及后1小时采集白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）。在康复训练前（T0）和康复训练后（T7）测定对最大运动的ACR。在整个康复期间的第2周（T2）、第4周（T4）和结束时（T7），测定对等距离运动（基于初始ISWT距离）的ACR（测试前/后）。
12名患者完成了研究。康复训练后最大ISWT距离显著增加。整个过程中基线细胞因子水平没有显著变化；康复训练前、期间或之后运动前/后细胞因子水平也没有显著变化。
训练前后与最大运动相关的炎症反应均不显著。对固定运动量运动的细胞因子反应在整个过程中没有明显改变。临床肺康复不太可能加剧COPD患者的全身炎症反应。
