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危重症患者使用自行车测力计后的氧化应激与免疫系统分析

Oxidative stress and immune system analysis after cycle ergometer use in critical patients.

作者信息

França Eduardo Eriko Tenório de, Ribeiro Luana Carneiro, Lamenha Gabriela Gomes, Magalhães Isabela Kalline Fidelix, Figueiredo Thainá de Gomes, Costa Marthley José Correia, Elihimas Ubiracé Fernando, Feitosa Bárbara Luana, Andrade Maria do Amparo, Correia Marco Aurélio Valois, Ramos Francimar Ferrari, Castro Célia Maria Machado Barbosa de

机构信息

Universidade Católica de Pernambuco (UNICAP), Fisioterapia, Recife/PE, Brazil.

Universidade Federal de Pernambuco (UFPE), Fisioterapia, Recife/PE, Brazil.

出版信息

Clinics (Sao Paulo). 2017 Mar;72(3):143-149. doi: 10.6061/clinics/2017(03)03.

Abstract

OBJECTIVE

: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients.

METHODS

: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol.

RESULTS

: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups.

CONCLUSION

: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results.

摘要

目的

被动式循环测力计旨在预防肌肉萎缩并增强肌肉力量,从而缩短重症监护病房的住院时间并改善功能。然而,其对氧化应激和免疫系统参数的影响尚不清楚。本研究的目的是分析被动式循环测力计对危重症患者免疫系统和氧化应激的影响。

方法

本文描述了一项随机对照试验,研究对象为19名在阿加梅农·马加良斯医院重症监护病房接受机械通气的男女患者。患者分为两组:一组患者在下肢以每分钟30次循环的速度进行20分钟的被动式循环测力计运动;另一组在研究期间未接受任何治疗干预,作为对照组。共分析20毫升血液,在研究方案前后评估其中的一氧化氮水平以及一些特定的炎性细胞因子(肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)、白细胞介素6(IL-6)和白细胞介素10(IL-10))。

结果

关于人口统计学和临床变量,两组在研究早期具有同质性。一氧化氮分析显示,与对照组相比,使用被动式循环测力计后,刺激细胞中的一氧化氮变化减少(p = 0.0021),刺激后的一氧化氮变化也减少(p = 0.0076)。两组之间在评估的炎性细胞因子方面未观察到差异。

结论

我们可以得出结论,被动式循环测力计可降低一氧化氮水平,对减轻氧化应激具有有益作用。通过炎性细胞因子评估,该治疗与免疫系统变化无关。然而,需要在更多人群中进行进一步研究以获得更具决定性的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd4/5348577/7d15f97ea8dd/cln-72-03-143-g001.jpg

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