Warner J T, Bell W, Webb D K, Gregory J W
University of Wales College of Medicine, Heath Park, Cardiff.
Arch Dis Child. 1997 Apr;76(4):298-303. doi: 10.1136/adc.76.4.298.
Many long term sequelae result from previous treatment for malignancy in childhood. However, little information exists on cardiopulmonary response and energy expenditure during exercise and their possible associations with excess body fat. Measurements of body composition and exercise capacity both at low intensity and maximal aerobic capacity were made on 56 long term survivors of childhood malignancy (35 survivors of acute lymphoblastic leukaemia (ALL) and 21 survivors of other malignancies) and 32 siblings acting as controls. Female survivors of ALL had significantly greater mean (SD) body fat than survivors of other malignancies and siblings (32.5 (6.4)% v 24.3 (4.4)% and 26.3 (8.5)% respectively, p < 0.005). Energy expenditure at low intensity exercise was reduced in survivors of ALL, and negatively correlated with body fat after controlling for weight (partial r range -0.21 to -0.47, p < 0.05). Stroke volume, measured indirectly, was reduced and heart rate raised in ALL survivors at sub-maximal exercise levels. Peak oxygen consumption was significantly reduced in girls and boys treated for ALL compared with siblings (30.5 v 41.3 ml/kg/min for girls, p < 0.05 and 39.9 v 47.6 ml/kg/min for boys, p < 0.05 respectively). Reduced exercise capacity may account in part for the excess adiposity observed in long term survivors of ALL.
许多长期后遗症源于儿童期恶性肿瘤的既往治疗。然而，关于运动期间心肺反应和能量消耗及其与体脂过多的可能关联的信息却很少。对56名儿童期恶性肿瘤长期幸存者（35名急性淋巴细胞白血病（ALL）幸存者和21名其他恶性肿瘤幸存者）以及32名作为对照的同胞进行了身体成分测量以及低强度和最大有氧能力下的运动能力测量。ALL女性幸存者的平均（标准差）体脂显著高于其他恶性肿瘤幸存者和同胞（分别为32.5（6.4）%、24.3（4.4）%和26.3（8.5）%，p<0.005）。ALL幸存者在低强度运动时的能量消耗降低，在控制体重后与体脂呈负相关（偏相关系数范围为-0.21至-0.47，p<0.05）。在次最大运动水平下，ALL幸存者间接测量的每搏输出量降低，心率升高。与同胞相比，接受ALL治疗的女孩和男孩的最大摄氧量显著降低（女孩为30.5对41.3毫升/千克/分钟，p<0.05；男孩为39.9对47.6毫升/千克/分钟，p<0.05）。运动能力下降可能部分解释了ALL长期幸存者中观察到的肥胖过多现象。
