Dept of Clinical Physiology, Centre Hospitalier Regional Universitaire Montpellier, University of Montpellier I, University of Montpellier II, Montpellier, France.
Eur Respir J. 2013 Apr;41(4):806-14. doi: 10.1183/09031936.00053512. Epub 2012 Jul 12.
The impaired skeletal muscle of chronic obstructive pulmonary disease (COPD) patients reduces exercise capacity. Similar to the oxidative muscle fibres, the angio-adaptation of muscle to training may be blunted in these patients, as in other chronic conditions. We therefore compared muscle functional responses and angio-adaptations after training in COPD patients and sedentary healthy subjects (SHS). 24 COPD patients (forced expiratory volume in 1 s 45.6 ± 17.5% predicted) and 23 SHS (<150 min · week(-1) of moderate-to-vigorous exercise) completed a 6-week rehabilitation programme based on individualised moderate-intensity endurance training. Histomorphological muscle analysis and measurements of pro-angiogenic vascular endothelial growth factor (VEGF)-A and anti-angiogenic thrombospondin (TSP)-1 were conducted before and after training. COPD patients and SHS showed improved symptom-limited oxygen consumption and muscle endurance, although improvements were lower in COPD patients (+0.96 ± 2.4 versus +2.9 ± 2.6 mL · kg(-1) · min(-1), p<0.05, and +65% versus +108%, p = 0.06, respectively). The capillary-to-fibre (C/F) ratio increased less in COPD patients than SHS (+16 ± 10% versus +37 ± 20%, p<0.05) and no fibre type switch occurred in COPD patients. The VEGF-A/TSP-1 ratio increased in COPD patients and SHS (+65% versus +35%, p<0.05). Changes in C/F and symptom-limited oxygen consumption were correlated (r = 0.51, p<0.05). In addition to a lack of fibre switch, COPD patients displayed a blunted angiogenic response to training.
慢性阻塞性肺疾病（COPD）患者的骨骼肌受损，导致运动能力下降。与氧化型肌纤维类似，COPD 患者的肌肉对训练的血管适应能力可能减弱，这种情况在其他慢性疾病中也存在。因此，我们比较了 COPD 患者和久坐健康受试者（SHS）在训练后的肌肉功能反应和血管适应能力。24 名 COPD 患者（1 秒用力呼气量占预计值的 45.6±17.5%）和 23 名 SHS（每周中到高强度运动<150 分钟）完成了为期 6 周的个体化中等强度耐力训练康复计划。在训练前后进行了组织形态学肌肉分析和促血管生成血管内皮生长因子（VEGF）-A 和抗血管生成血栓素（TSP）-1 的测量。COPD 患者和 SHS 的症状限制摄氧量和肌肉耐力都有所改善，尽管 COPD 患者的改善程度较低（分别为+0.96±2.4 对+2.9±2.6 mL·kg-1·min-1，p<0.05，和+65%对+108%，p=0.06）。与 SHS 相比，COPD 患者的毛细血管与纤维（C/F）比值增加较少（分别为+16±10%对+37±20%，p<0.05），并且 COPD 患者没有发生纤维类型转换。COPD 患者和 SHS 的 VEGF-A/TSP-1 比值增加（分别为+65%对+35%，p<0.05）。C/F 和症状限制摄氧量的变化呈正相关（r=0.51，p<0.05）。除了缺乏纤维转换之外，COPD 患者的血管生成对训练的反应也减弱了。
