Pehlivan Esra, Zeren Melih, Özcan Zeynep Betül, Karaahmetoğlu Fulya Senem, Demirkol Barış, İlhan Umut, Ataç Amine, Çetinkaya Erdoğan
University of Health Sciences Turkey, Faculty of Hamidiye Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
Izmir Bakircay University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, İzmir, Turkey.
Sarcoidosis Vasc Diffuse Lung Dis. 2025 Mar 18;42(1):15942. doi: 10.36141/svdld.v42i1.15942.
The impact of fibrosing interstitial lung disease (F-ILD) on the oxygenation of peripheral and respiratory muscles during exercise remains poorly understood. Specifically, it's unclear whether regional blood flow influences exercise capacity in these patients, and if so, to what degree.
This study aimed to investigate changes in oxygenation and blood flow volume of the intercostal (IC) and quadriceps femoris (QF) muscles during exercise in patients with F-ILD.
Muscle oxygenation (SmO2) and total haemoglobin (tHb) changes of IC and QF were measured in 36 F-ILD patients using near-infrared spectroscopy (NIRS) during six-minute walking test (6MWT). Resting, minute-by-minute change, and average data were analyzed.
At rest, SmO2 was significantly higher in IC compared to QF (p<0.001). When adjusted for SmO2 at rest, SmO2 at the different time points during 6MWT, average SmO2 during 6MWT, and lowest SmO2 during 6MWT did not differ between QF and IC muscles. Also, SmO2 did not vary significantly during 6MWT in either QF (F=2.193) or IC muscle (F=1.262). THb increased more in QF than in IC. THb of IC inversely correlated to respiratory functions and 6MWT distance.
Peripheral and respiratory muscle oxygenation in F-ILD seems to be normal. However, blood flow volume in exercising muscle, not muscle oxygenation, may be a contributing factor to exercise intolerance. Patients with poorer respiratory function may require excessive blood flow in their respiratory muscles which in turn may limit the blood flow available for exercising peripheral muscles.
纤维化间质性肺疾病（F-ILD）对运动期间外周肌肉和呼吸肌氧合的影响仍知之甚少。具体而言，尚不清楚局部血流是否会影响这些患者的运动能力，若有影响，程度如何。
本研究旨在调查F-ILD患者运动期间肋间肌（IC）和股四头肌（QF）的氧合及血流量变化。
在36例F-ILD患者进行六分钟步行试验（6MWT）期间，使用近红外光谱（NIRS）测量IC和QF的肌肉氧合（SmO2）和总血红蛋白（tHb）变化。分析静息、每分钟变化及平均数据。
静息时，IC的SmO2显著高于QF（p<0.001）。在对静息时的SmO2进行校正后，6MWT期间不同时间点的SmO2、6MWT期间的平均SmO2以及6MWT期间的最低SmO2在QF和IC肌肉之间并无差异。此外，在6MWT期间，QF（F=2.193）或IC肌肉（F=1.262）的SmO2均无显著变化。QF的tHb增加幅度大于IC。IC的tHb与呼吸功能和6MWT距离呈负相关。
F-ILD患者的外周肌肉和呼吸肌氧合似乎正常。然而，运动肌肉的血流量而非肌肉氧合可能是导致运动不耐受的一个因素。呼吸功能较差的患者可能需要其呼吸肌有过多的血流量，这反过来可能会限制可用于运动外周肌肉的血流量。
