下肢功能性电刺激可降低慢性脊髓损伤患者的血小板聚集和血液凝固：一项初步研究。
Lower-extremity functional electrical stimulation decreases platelet aggregation and blood coagulation in persons with chronic spinal cord injury: a pilot study.
作者信息
Kahn Nighat N, Feldman Susan P, Bauman William A
机构信息
Center of Excellence, James J. Peters VA Medical Center, 130 W. Kingsbridge Road, Bronx, NY 10468, USA.
出版信息
J Spinal Cord Med. 2010;33(2):150-8. doi: 10.1080/10790268.2010.11689690.
BACKGROUND
Individuals with spinal cord injury (SCI) develop premature cardiovascular disease. Regular exercise reduces the incidence and symptoms of cardiovascular disease in able-bodied individuals; these salutary effects of exercise have not been documented in persons with SCI.
OBJECTIVE
To evaluate the effects of functional electrical stimulation leg cycle ergometry (FES-LCE) exercise training on platelet aggregation and blood coagulation in persons with SCI.
PARTICIPANTS
Subjects (n=14) with stable chronic (>1 year) paraplegia (T1-T10) or tetraplegia (C4-C8).
METHODS
Blood samples were collected before and after the first and eighth sessions (2 sessions per week for 4 weeks) of FES exercise.
RESULTS
Platelet aggregation was inhibited by 20% after the first session and by 40% (P < 0.001) after the eighth session. Thrombin activity was unchanged after the first session (10.7 +/- 0.85 s to 10.43 +/- 0.56 s) and decreased after the eighth session (12.5 +/- 1.98 s to 11.1 +/- 1.7 s; P < 0.0003). Antithrombin III activity increased after the first (103.8% +/- 8.9% to 110% +/- 6.9%; P < 0.0008) and eighth sessions (107.8% +/- 12.1% to 120.4% +/- 13.1%; P < 0.0001). Cyclic adenosine monophosphate increased after the first (9.9% + 2.5% to 15.8% +/- 3%; P < 0.001) and eighth sessions (17.8% +/- 4.2% to 36.5% +/- 7.6%; P < 0.0001). After the eighth session, factors V and X increased significantly (88% +/- 27% to 103% +/- 23%, P < 0.0001; 100% +/- 40% to 105% +/- 7%, P < 0.01, respectively); factors VII and VIII and fibrinogen did not change significantly. A significant reduction in platelet activation/aggregation was demonstrated in response to FES-LCE. The decrease in thrombin level was caused by the simultaneous increase in antithrombin activity.
CONCLUSION
These findings provide new insight into the potential protective effects of FES-LCE against the risk of cardiovascular disease.
背景
脊髓损伤（SCI）患者会过早患上心血管疾病。规律运动可降低健康个体心血管疾病的发病率和症状；但这些运动的有益效果在脊髓损伤患者中尚未得到证实。
目的
评估功能性电刺激腿部循环测力计（FES-LCE）运动训练对脊髓损伤患者血小板聚集和血液凝固的影响。
参与者
患有稳定慢性（>1年）截瘫（T1-T10）或四肢瘫（C4-C8）的受试者（n=14）。
方法
在FES运动的第一和第八次训练前及训练后（每周2次，共4周）采集血样。
结果
第一次训练后血小板聚集受到20%的抑制，第八次训练后受到40%的抑制（P<0.001）。第一次训练后凝血酶活性未改变（从10.7±0.85秒变为10.43±0.56秒），而第八次训练后降低（从12.5±1.98秒变为11.1±1.7秒；P<0.0003）。抗凝血酶III活性在第一次（从103.8%±8.9%变为110%±6.9%；P<0.0008）和第八次训练后增加（从107.8%±12.1%变为120.4%±13.1%；P<0.0001）。环磷酸腺苷在第一次（从9.9%+2.5%变为15.8%±3%；P<0.001）和第八次训练后增加（从17.8%±4.2%变为36.5%±7.6%；P<0.0001）。第八次训练后，因子V和X显著增加（分别从88%±27%变为103%±23%，P<0.0001；从100%±40%变为105%±7%，P<0.01）；因子VII、VIII和纤维蛋白原无显著变化。FES-LCE可显著降低血小板活化/聚集。凝血酶水平的降低是由抗凝血酶活性的同时增加引起的。
结论
这些发现为FES-LCE对心血管疾病风险的潜在保护作用提供了新的见解。
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