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慢性脑卒中患者摄氧量动力学的潜在机制:相关性、横断面初步研究。

Underlying mechanisms of oxygen uptake kinetics in chronic post-stroke individuals: A correlational, cross-sectional pilot study.

机构信息

Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.

Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States of America.

出版信息

PLoS One. 2020 Nov 9;15(11):e0241872. doi: 10.1371/journal.pone.0241872. eCollection 2020.

Abstract

Post-stroke individuals presented deleterious changes in skeletal muscle and in the cardiovascular system, which are related to reduced oxygen uptake ([Formula: see text]) and take longer to produce energy from oxygen-dependent sources at the onset of exercise (mean response time, MTRON) and during post-exercise recovery (MRTOFF). However, to the best of our knowledge, no previous study has investigated the potential mechanisms related to [Formula: see text] kinetics response (MRTON and MRTOFF) in post-stroke populations. The main objective of this study was to determine whether the MTRON and MRTOFF are related to: 1) body composition; 2) arterial compliance; 3) endothelial function; and 4) hematological and inflammatory profiles in chronic post-stroke individuals. Data on oxygen uptake ([Formula: see text]) were collected using a portable metabolic system (Oxycon Mobile®) during the six-minute walk test (6MWT). The time to achieve 63% of [Formula: see text] during a steady state (MTRON) and recovery (MRTOFF) were analyzed by the monoexponential model and corrected by a work rate (wMRTON and wMRTOFF) during 6MWT. Correlation analyses were made using Spearman's rank correlation coefficient (rs) and the bias-corrected and accelerated bootstrap method was used to estimate the 95% confidence intervals. Twenty-four post-stroke participants who were physically inactive took part in the study. The wMRTOFF was correlated with the following: skeletal muscle mass (rs = -0.46), skeletal muscle mass index (rs = -0.45), augmentation index (rs = 0.44), augmentation index normalized to a heart rate of 75 bpm (rs = 0.64), reflection magnitude (rs = 0.43), erythrocyte (rs = -0.61), hemoglobin (rs = -0.54), hematocrit (rs = -0.52) and high-sensitivity C-reactive protein (rs = 0.58), all p < 0.05. A greater amount of oxygen uptake during post-walking recovery is partially related to lower skeletal muscle mass, greater arterial stiffness, reduced number of erythrocytes and higher systemic inflammation in post-stroke individuals.

摘要

中风后个体的骨骼肌和心血管系统会发生有害变化,这与运动起始时(平均反应时间,MTRON)和运动后恢复时(MRTOFF)从依赖氧的来源产生能量的能力降低以及氧气摄取量 ([Formula: see text]) 有关。然而,据我们所知,以前没有研究调查过与中风后人群的 [Formula: see text] 动力学反应(MRTON 和 MRTOFF)相关的潜在机制。本研究的主要目的是确定 MTRON 和 MRTOFF 是否与以下因素相关:1)身体成分;2)动脉顺应性;3)内皮功能;以及 4)慢性中风后个体的血液学和炎症特征。使用便携式代谢系统(Oxycon Mobile®)在六分钟步行测试(6MWT)期间收集氧气摄取量 ([Formula: see text]) 数据。通过单指数模型分析达到稳态时的 [Formula: see text] 的 63%所需的时间(MTRON)和恢复时的时间(MRTOFF),并通过 6MWT 中的工作率(wMRTON 和 wMRTOFF)进行校正。使用 Spearman 等级相关系数(rs)进行相关分析,并使用偏置校正和加速自举法估计 95%置信区间。24 名身体活动不足的中风后参与者参加了研究。wMRTOFF 与以下因素相关:骨骼肌质量(rs = -0.46)、骨骼肌质量指数(rs = -0.45)、增强指数(rs = 0.44)、增强指数归一化为 75 bpm 的心率(rs = 0.64)、反射幅度(rs = 0.43)、红细胞(rs = -0.61)、血红蛋白(rs = -0.54)、红细胞压积(rs = -0.52)和高敏 C 反应蛋白(rs = 0.58),均 p < 0.05。运动后恢复期间摄取的氧气量增加部分与骨骼肌质量较低、动脉僵硬程度较高、红细胞数量减少以及中风后个体的全身性炎症增加有关。

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