Griffiths R D, Palmer T E, Helliwell T, MacLennan P, MacMillan R R
Department of Medicine, University of Liverpool, United Kingdom.
Nutrition. 1995 Sep-Oct;11(5):428-32.
This study examine whether muscle wasting in critically ill patients can be prevented by passive stretching alone in the absence of contractile activity. Five critically ill patients who required a complete neuromuscular blockade for 7 days of ventilator support were studied. One leg of each patient was treated with continuous passive motion (CPM) for three 3-h periods daily while the other leg received only routine nursing care. Fiber atrophy was prevented in the more severely ill patients and there was a slight gain in fiber area (mean increase, +11%) in the CPM limb compared with the control leg, which decreased (mean decrease, -35%) over 7 days. Fiber area was preserved in both fiber types but was more pronounced in type I muscle fibers. Protein loss was significantly less in the CPM limb. There was a significantly greater increase in wet weight per mg DNA in the control limb. However, as an index of wasting, the ratio of protein to DNA decreased similarly in both limbs. Passive stretching can preserve the architecture of muscle fibers. Whether it can prevent muscle wasting remains uncertain.
本研究探讨在无收缩活动的情况下，单纯被动拉伸是否可预防危重症患者的肌肉萎缩。对5例需要进行7天呼吸机支持的完全性神经肌肉阻滞的危重症患者进行了研究。每位患者的一条腿每天接受3个3小时疗程的持续被动运动（CPM）治疗，而另一条腿仅接受常规护理。在病情较重的患者中，纤维萎缩得到了预防，与对照腿相比，接受CPM治疗的肢体纤维面积略有增加（平均增加+11%），而对照腿在7天内减少（平均减少-35%）。两种纤维类型的纤维面积均得以保留，但在I型肌纤维中更为明显。CPM治疗的肢体蛋白质损失明显较少。对照肢体每毫克DNA的湿重增加明显更大。然而，作为萎缩指标，两肢体蛋白质与DNA的比值下降相似。被动拉伸可保留肌纤维结构。它是否能预防肌肉萎缩仍不确定。
