Tada H, Kato H, Misawa T, Takahashi H, Hayashi S, Hayashi T, Kutsumi Y, Ishizaki T, Nakai T, Miyabo S
Third Department of Internal Medicine, Fukui Medical School, Fukui.
J Cardiol. 1993;23(3):293-9.
The metabolism of the skeletal muscles during exercise and recovery was investigated using phosphocreatinine (PCr) and inorganic phosphate (Pi) in patients with chronic heart failure. PCr/Pi ratio, which is closely related to the ATP/ADP ratio, and the pH were measured by 31P-magnetic resonance spectroscopy (31P-MRS) during and after forearm exercise in 9 patients with chronic heart failure, 11 patients with chronic lung disease, and 8 normal subjects. Exercise and recovery scans were recorded every minute for 4 min. The PCr/Pi ratio in patients was lower during the recovery period and significantly lower 3 and 4 min after exercise than in normal subjects. The pH values after exercise were lower in patients, although not significantly. The PCr/Pi ratio 4 min after exercise in patients was not correlated with parameters of cardiac function or arterial and mixed venous oxygen tension. Nutritional parameters did not vary statistically among the groups. Metabolic abnormalities may be present in the skeletal muscles of patients' group, which are not due to undernutrition, possibly as a result of exercise deconditioning and probably a shift in fiber distribution (type I decreases, type IIb increases) and a decrease in oxidative capacity.
利用磷酸肌酸（PCr）和无机磷酸盐（Pi）对慢性心力衰竭患者运动及恢复过程中的骨骼肌代谢进行了研究。在9例慢性心力衰竭患者、11例慢性肺病患者及8名正常受试者进行前臂运动期间及之后，通过31P磁共振波谱法（31P-MRS）测量了与ATP/ADP比率密切相关的PCr/Pi比率及pH值。运动及恢复扫描每分钟记录1次，共记录4分钟。患者在恢复期间的PCr/Pi比率较低，且运动后3分钟和4分钟时显著低于正常受试者。患者运动后的pH值也较低，不过差异不显著。患者运动后4分钟时的PCr/Pi比率与心功能参数、动脉血氧分压及混合静脉血氧分压均无相关性。各组间营养参数无统计学差异。患者组骨骼肌中可能存在代谢异常，这并非由营养不足所致，可能是运动能力下降的结果，或许还与纤维分布改变（I型减少，IIb型增加）及氧化能力降低有关。
