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慢性阻塞性肺疾病患者股四头肌与膈肌的比较评估

Comparative assessment of the quadriceps and the diaphragm in patients with COPD.

作者信息

Caron Marc-André, Debigaré Richard, Dekhuijzen P N Richard, Maltais François

机构信息

Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, Canada G1V 4G5.

出版信息

J Appl Physiol (1985). 2009 Sep;107(3):952-61. doi: 10.1152/japplphysiol.00194.2009. Epub 2009 Apr 9.

Abstract

Chronic obstructive pulmonary disease (COPD) and other chronic diseases such as heart failure are accompanied by skeletal muscle alterations that further enhance morbidity and mortality in affected individuals. Several studies have highlighted important structural and biochemical modifications in limb and respiratory muscles in COPD. Reviewing the similarities and differences between the two most studied muscles in COPD, the quadriceps and the diaphragm, may be helpful in providing important clues about the mechanisms underlying muscle changes associated with this disease. Although oxidative stress is present in both muscles, other muscle alterations are clearly distinct between the quadriceps and the diaphragm. For example, the oxidative metabolism varies in opposite directions, the diaphragm exhibiting increased resistance to fatigue while the quadriceps in COPD is characterized by premature fatigability. Differences in muscle phenotypic expression between the diaphragm and the quadriceps indicate that, in addition to systemic factors, the local microenvironment must participate in the reorganization seen in these two skeletal muscles in COPD.

摘要

慢性阻塞性肺疾病(COPD)以及其他慢性疾病,如心力衰竭,都伴有骨骼肌改变,这进一步增加了受影响个体的发病率和死亡率。多项研究强调了COPD患者肢体肌肉和呼吸肌中重要的结构和生化改变。回顾COPD中研究最多的两块肌肉——股四头肌和膈肌之间的异同,可能有助于为与该疾病相关的肌肉变化机制提供重要线索。尽管两块肌肉中都存在氧化应激,但股四头肌和膈肌的其他肌肉改变明显不同。例如,氧化代谢呈相反方向变化,膈肌表现出对疲劳的抵抗力增加,而COPD患者的股四头肌则具有过早疲劳的特征。膈肌和股四头肌之间肌肉表型表达的差异表明,除了全身因素外,局部微环境必定参与了COPD患者这两块骨骼肌中所见的重组过程。

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