Lohrer Heinz, Klein Jochen, Nauck Tanja, Schönberg Tobias
ESN - European SportsCare Network, Borsigstrasse 2, 65205, Wiesbaden, Germany.
Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany.
BMC Sports Sci Med Rehabil. 2021 Mar 5;13(1):21. doi: 10.1186/s13102-021-00245-9.
Diagnosing chronic exertional compartment syndrome (CECS) is still a challenge. An increase in intramuscular pressure during and following exercise is accepted as the diagnostic standard. However, neither the methods used nor the interpretation of the obtained results are sufficiently standardized.
In the present pilot study, the metabolic state of CECS patients was investigated using microdialysis. We hypothesized that there was no difference in intramuscular concentrations of glucose, lactate, glutamate, and glycerol before and after exercise (H1) or between patients suffering from CECS and healthy control subjects (H2). This study was designed as an explorative case-control study (level of evidence III). Twelve patients suffering from CECS of the lower leg and six matched asymptomatic control subjects underwent microdialysis in the anterior (n = 7) or deep posterior compartment (n = 11) of the leg. Following ultrasound-guided insertion of the microdialysis catheters, 10-minute fractions of the dialysates were collected first during rest and then following fatigue- or pain-induced discontinuation of exercise. Dialysates were analysed for lactate, glucose, glutamate, and glycerol concentrations 6 × 10 min before and 6 × 10 min after exercise.
Exercise-induced increases in lactate, glutamate, and glycerol concentrations were detected in both CECS patients and control subjects (all p < 0.001). No differences between CECS patients and control subjects were found by comparing the intramuscular glucose, lactate, glutamate, and glycerol concentrations at rest and following exercise (all p > 0.05).
We found exercise-induced increases in the lactate, glutamate, and glycerol levels in skeletal muscle. However, the metabolic changes did not differentiate CECS patients from healthy subjects.
The registration trial number is DRKS00021589 on DRKS. 'Retrospectively registered'. Date of registration: April 4, 2020.
诊断慢性运动性骨筋膜室综合征（CECS）仍然是一项挑战。运动期间及运动后肌肉内压力升高被视为诊断标准。然而，所使用的方法以及对所得结果的解读都不够标准化。
在本初步研究中，使用微透析技术研究了CECS患者的代谢状态。我们假设运动前后肌肉内葡萄糖、乳酸、谷氨酸和甘油的浓度没有差异（假设1），或者CECS患者与健康对照受试者之间没有差异（假设2）。本研究设计为探索性病例对照研究（证据级别III）。12名下腿部患有CECS的患者和6名匹配的无症状对照受试者在小腿前侧（n = 7）或后侧深部骨筋膜室（n = 11）接受了微透析。在超声引导下插入微透析导管后，首先在休息期间收集10分钟的透析液样本，然后在因疲劳或疼痛导致运动停止后收集。对运动前6×10分钟和运动后6×10分钟的透析液进行乳酸、葡萄糖、谷氨酸和甘油浓度分析。
在CECS患者和对照受试者中均检测到运动诱导的乳酸、谷氨酸和甘油浓度升高（所有p < 0.001）。通过比较休息时和运动后肌肉内葡萄糖、乳酸、谷氨酸和甘油的浓度，未发现CECS患者与对照受试者之间存在差异（所有p > 0.05）。
我们发现运动可诱导骨骼肌中乳酸、谷氨酸和甘油水平升高。然而，这些代谢变化并未区分CECS患者与健康受试者。
试验注册号为DRKS上的DRKS00021589。“回顾性注册”。注册日期：2020年4月4日。
