运动强度与沙丁胺醇对囊性纤维化患者的影响比较。
Effects of exercise intensity compared to albuterol in individuals with cystic fibrosis.
作者信息
Wheatley Courtney M, Baker Sarah E, Morgan Mary A, Martinez Marina G, Morgan Wayne J, Wong Eric C, Karpen Stephen R, Snyder Eric M
机构信息
Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA; Department of Kinesiology, University of Minnesota, Minneapolis, MN, USA.
出版信息
Respir Med. 2015 Apr;109(4):463-74. doi: 10.1016/j.rmed.2014.12.002. Epub 2014 Dec 18.
BACKGROUND
Although exercise is a vital component of the therapy prescribed to individuals with cystic fibrosis (CF), it is not a priority due to a finite amount of treatment time and the view that exercise is not as beneficial as pharmacological treatments by many individuals with CF. We sought to compare the therapeutic benefits of exercise and their prescribed bronchodilator albuterol.
METHODS
CF (n = 14) and healthy (n = 16) subjects completed three visits, a baseline screening with VO2 max test and two treatment visits. On the two treatment visits, subjects completed spirometry and diffusing capacity of the lungs for nitric oxide (DLNO) maneuvers either at baseline, 60, and 110 min post-albuterol administration, or at baseline and the midway point of three separate 15 min exercise bouts at low, moderate and vigorous intensity (25, 50 and 65% of the maximum workload, respectively).
RESULTS
With moderate exercise the increase in DLNO was double (39 ± 8 vs 15 ± 6% change) and the level of bronchodilation similar (23% change) when compared to 110 min post-albuterol in individuals with CF. During exercise FVC became reduced (-309 ± 66 mL with moderate exercise) and the increase in FEV1 was attenuated (103 ± 39 vs 236 ± 58 mL, exercise vs. albuterol) when compared with the response to albuterol in individuals with CF. Epinephrine (EPI) release increased 39, 72 and 144% change with low, moderate and vigorous intensity exercise respectively for individuals with CF, but this increase was blunted when compared to healthy subjects.
CONCLUSION
Our results suggest that moderate intensity exercise is the optimal intensity for individuals with CF, as low intensity exercise increases EPI less than 50% and vigorous intensity exercise is over taxing, such that airflow can be restricted. Although the duration of the beneficial effect is uncertain, exercise can promote greater improvements in gas diffusion and comparable bronchodilation when compared to albuterol.
背景
尽管运动是囊性纤维化（CF）患者规定治疗的重要组成部分，但由于治疗时间有限，且许多CF患者认为运动不如药物治疗有益，因此运动并非首要任务。我们试图比较运动及其规定使用的支气管扩张剂沙丁胺醇的治疗效果。
方法
CF患者（n = 14）和健康受试者（n = 16）完成三次就诊，一次是进行最大摄氧量测试的基线筛查，以及两次治疗就诊。在两次治疗就诊时，受试者在基线、沙丁胺醇给药后60分钟和110分钟，或在基线以及三次分别为15分钟的低、中、高强度运动（分别为最大工作量的25%、50%和65%）回合的中点，完成肺量计检查和肺一氧化氮弥散量（DLNO）操作。
结果
与CF患者沙丁胺醇给药后110分钟相比，进行中等强度运动时，CF患者的DLNO增加量翻倍（变化率为39±8%对15±6%），支气管扩张水平相似（变化率为23%）。在运动期间，与CF患者对沙丁胺醇的反应相比，用力肺活量（FVC）降低（中等强度运动时降低309±66毫升），第一秒用力呼气容积（FEV1）的增加减弱（运动时为103±39毫升，沙丁胺醇时为236±58毫升）。CF患者低、中、高强度运动时肾上腺素（EPI）释放分别增加39%、72%和144%，但与健康受试者相比，这种增加有所减弱。
结论
我们的结果表明，中等强度运动对CF患者是最佳强度，因为低强度运动使EPI增加不到50%，而高强度运动负荷过大，可能会限制气流。尽管有益效果的持续时间不确定，但与沙丁胺醇相比，运动可促进气体扩散有更大改善且支气管扩张程度相当。
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