Newcastle Magnetic Resonance Centre, Newcastle University, UK.
J Hepatol. 2010 Jul;53(1):155-61. doi: 10.1016/j.jhep.2010.02.022. Epub 2010 Mar 31.
BACKGROUND & AIMS: Upon exercise, primary biliary cirrhosis (PBC) is associated with significant acidosis in peripheral muscle with recovery rate from acidosis strongly associating with fatigue. PBC patients describe particular problems with repeat exercise describing subsequent exercise episodes being limited by perceived effects of the first. We modelled this effect by exploring kinetics of pH recovery during 3 linked exercise episodes using magnetic resonance spectroscopy (MRS).
Muscle acid handling capacity was studied following 3 x 3 min exercise periods at 35% maximum voluntary capacity in matched fatigued PBC, non-fatigued PBC and healthy controls (n=8 per group).
Time to pH recovery following initial exercise was prolonged in PBC compared to controls (160 s [60-390] vs. 25 [0-180], p=0.005) with the longest recovery time seen in fatigued patients (median 210 s). All subjects shortened recovery time between exercise periods 1-2 (controls: mean -28%, non-fatigued PBC patients: -29% and fatigued PBC patients: -30%. Normals showed further recovery shortening between exercise periods 2-3 (-18%, p=ns vs. period 1-2 recovery) however this adaptive response was lost in non-fatigued PBC patients (+3%) and reversed in fatigued patients (+19%, p=0.01 vs. period 1-2).
PBC patients retain the physiological capacity to shorten pH recovery time following repeat exercise. Capacity to shorten recovery time after a 2nd exercise period is lost in low-fatigue PBC patients and replaced by recovery prolongation in fatigued patients. Improvement in post-exercise acid recovery through exercise therapy should be possible in PBC patients and could be a novel approach to peripheral fatigue treatment.
原发性胆汁性肝硬化（PBC）患者在进行运动时，外周肌肉会出现明显酸中毒，而酸中毒的恢复速度与疲劳程度密切相关。PBC 患者特别描述了在重复运动时出现的问题，他们描述说，后续运动受到第一次运动的影响，运动次数受限。我们通过使用磁共振光谱（MRS）探索 3 次连续运动期间 pH 值恢复的动力学来模拟这种影响。
我们在匹配的疲劳性 PBC、非疲劳性 PBC 和健康对照组中（每组 8 人），研究了 3 次 3 分钟、最大自主容量的 35%的运动周期后肌肉酸处理能力。
与对照组相比，PBC 患者在初始运动后恢复 pH 值的时间延长（160 秒[60-390]比 25 秒[0-180]，p=0.005），疲劳患者的恢复时间最长（中位数 210 秒）。所有受试者在运动 1-2 期间缩短了恢复时间（对照组：平均-28%，非疲劳性 PBC 患者：-29%，疲劳性 PBC 患者：-30%。正常组在运动 2-3 期间进一步缩短了恢复时间（-18%，p=ns 与运动 1-2 恢复相比），但这种适应性反应在非疲劳性 PBC 患者中丢失（3%），在疲劳性患者中逆转（+19%，p=0.01 与运动 1-2 恢复相比）。
PBC 患者在重复运动后保持缩短 pH 值恢复时间的生理能力。在低疲劳性 PBC 患者中，第二次运动后缩短恢复时间的能力丧失，而疲劳患者的恢复时间延长。通过运动治疗改善运动后酸恢复应该是可能的，并且可能是治疗周围性疲劳的一种新方法。
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