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使用超声回波评估运动强度与肾血流量之间的关联。

Association between exercise intensity and renal blood flow evaluated using ultrasound echo.

作者信息

Kawakami Shotaro, Yasuno Tetsuhiko, Matsuda Takuro, Fujimi Kanta, Ito Ai, Yoshimura Saki, Uehara Yoshinari, Tanaka Hiroaki, Saito Takao, Higaki Yasuki

机构信息

Department of Rehabilitation, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-0067, Japan.

Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0133, Japan.

出版信息

Clin Exp Nephrol. 2018 Oct;22(5):1061-1068. doi: 10.1007/s10157-018-1559-1. Epub 2018 Mar 10.

Abstract

BACKGROUND

High-intensity exercise reduces renal blood flow (RBF) and may transiently exacerbate renal dysfunction. RBF has previously been measured invasively by administration of an indicator material; however, non-invasive measurement is now possible with technological innovations. This study examined variations in RBF at different exercise intensities using ultrasound echo.

METHODS

Eight healthy men with normal renal function (eGFR 114 ± 19 mL/min/1.73 m) participated in this study. Using a bicycle ergometer, participants underwent an incremental exercise test using a ramp protocol (20 W/min) until exhaustion in Study 1 and the lactate acid breaking point (LaBP) was calculated. Participants underwent a multi-stage test at exercise intensities of 60, 80, 100, 120, and 140% LaBP in Study 2. RBF was measured by ultrasound echo at rest and 5 min after exercise in Study 1 and at rest and immediately after each exercise in Study 2. To determine the mechanisms behind RBF decline, a catheter was placed into the antecubital vein to study vasoconstriction dynamics.

RESULTS

RBF after maximum exercise decreased by 51% in Study 1. In Study 2, RBF showed no significant decrease until 80% LaBP, and showed a significant decrease (31%) at 100% LaBP compared with at rest (p < 0.01). The sympathetic nervous system may be involved in this reduction in RBF.

CONCLUSIONS

RBF showed no significant decrease until 80% LaBP, and decreased with an increase in blood lactate. Reduction in RBF with exercise above the intensity at LaBP was due to decreased cross-sectional area rather than time-averaged flow velocity.

摘要

背景

高强度运动可降低肾血流量(RBF),并可能短暂加剧肾功能不全。此前RBF是通过给予指示物质进行有创测量的;然而,随着技术创新,现在已经可以进行无创测量。本研究使用超声回声检查不同运动强度下RBF的变化。

方法

8名肾功能正常(估算肾小球滤过率[eGFR]为114±19毫升/分钟/1.73平方米)的健康男性参与了本研究。在研究1中,参与者使用自行车测力计,采用斜坡方案(20瓦/分钟)进行递增运动试验直至力竭,并计算乳酸突破点(LaBP)。在研究2中,参与者在60%、80%、100%、120%和140%LaBP的运动强度下进行多级试验。在研究1中,于静息时和运动后5分钟通过超声回声测量RBF;在研究2中,于静息时和每次运动后立即测量RBF。为确定RBF下降背后的机制,将导管插入肘前静脉以研究血管收缩动力学。

结果

在研究1中,最大运动后RBF下降了51%。在研究2中,RBF在80%LaBP之前无显著下降,与静息时相比,在100%LaBP时显著下降(31%)(p<0.01)。交感神经系统可能参与了RBF的这种降低。

结论

RBF在80%LaBP之前无显著下降,并随血乳酸增加而降低。运动强度高于LaBP时RBF的降低是由于横截面积减小而非时间平均流速降低。

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