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炎症标志物与慢性心力衰竭患者疾病严重程度的关系:运动训练的影响有限。

Inflammatory markers as related to disease severity in patients with chronic heart failure: limited effects of exercise training.

机构信息

Center for Clinical Heart Research, Oslo University Hospital Ulleval, Norway.

出版信息

Scand J Clin Lab Invest. 2011 Nov;71(7):598-605. doi: 10.3109/00365513.2011.598943. Epub 2011 Aug 11.

Abstract

BACKGROUND

Chronic heart failure (CHF) is associated with increased inflammation, and exercise training has in some studies been shown to have anti-inflammatory effect, although controversies exist. We investigated the effects of exercise training in CHF patients on markers of inflammation, and further explored any association between inflammation and the severity and etiology of the disease.

METHODS

Eighty patients in stable CHF were randomized to 4 months of group-based high intensity exercise training or to a control group. Physical capacity was measured by 6-minute walk test and cycle ergometer test. Blood samples were drawn at baseline, after 4 months and after 12 months follow-up for analyses of a range of biomarkers.

RESULTS

Physical capacity was significantly inversely related to CRP, IL-6, VCAM-1 and TGF-β, and NT pro-BNP levels were significantly correlated to CRP, TNF-α, IL-6, VCAM-1, ICAM-1 and TGF-β (p < 0.05 for all). Patients with hypertension as etiology of CHF showed higher levels of CRP (p < 0.01), IL-6 (p = 0.05) and TNF-α (p = 0.02) as compared to other etiologies. No significant differences in changes between the exercise group and the control group were obtained in any of the measured variables, except in patients with idiopathic dilated cardiomyopathy (IDCM), where significant reductions in CRP, ICAM-1, TGF-β and TNF-α levels were observed (p < 0.05 for all).

CONCLUSIONS

Measures of CHF severity were significantly correlated with several markers of inflammation. We could not demonstrate over-all anti-inflammatory effect of exercise in this population of CHF patients. However, the etiology of CHF affected the inflammatory profile and the effect of exercise training.

摘要

背景

慢性心力衰竭(CHF)与炎症增加有关,一些研究表明运动训练具有抗炎作用,但存在争议。我们研究了运动训练对 CHF 患者炎症标志物的影响,并进一步探讨了炎症与疾病严重程度和病因之间的任何关联。

方法

80 例稳定期 CHF 患者随机分为 4 个月的小组高强度运动训练组或对照组。通过 6 分钟步行测试和循环测力计测试测量身体能力。在基线、4 个月和 12 个月随访时抽取血样,用于分析一系列生物标志物。

结果

身体能力与 CRP、IL-6、VCAM-1 和 TGF-β呈显著负相关,NT pro-BNP 水平与 CRP、TNF-α、IL-6、VCAM-1、ICAM-1 和 TGF-β显著相关(p<0.05)。CHF 病因是高血压的患者 CRP(p<0.01)、IL-6(p=0.05)和 TNF-α(p=0.02)水平较高。与对照组相比,运动组在任何测量变量中均未观察到显著变化,除特发性扩张型心肌病(IDCM)患者外,CRP、ICAM-1、TGF-β和 TNF-α水平显著降低(p<0.05)。

结论

CHF 严重程度的测量指标与几种炎症标志物显著相关。我们无法证明运动对该人群 CHF 患者具有总体抗炎作用。然而,CHF 的病因影响了炎症特征和运动训练的效果。

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