Adaptation of the diaphragm and the vastus lateralis in mild-to-moderate COPD
Adaptation of the diaphragm and the vastus lateralis in mild-to-moderate COPD
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DOI：
10.1183/09031936.04.00020204
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发表时间：
2004-12-01
影响因子：
24.3
通讯作者：
Maltais, F
中科院分区：
文献类型：
--
作者：
Doucet, M;Debigaré, R;Maltais, F
慢性阻塞性肺疾病（COPD）患者膈肌和股外侧肌适应的年表尚未研究。本研究的假设是，慢性阻塞性肺病患者膈肌的肌肉变化比股外侧肌更早发生，这一发现表明，在决定肌肉表型表达方面，局部因素比全身因素更重要，至少在轻中度疾病中如此。在轻度至中度COPD患者和肺功能正常的受试者中评估股外侧肌和膈肌的适应性。在两组中，膈肌的氧化电位和脂褐素包涵体数量均高于股外侧肌。与对照组相比，COPD患者膈膜具有更高的氧化能力和更高的I型纤维比例，IIA型纤维的比例相应减少，而膈横截面积、毛细血管化和脂褐素包涵体没有差异。两组的股外侧肌无明显差异。总之，这些数据表明，对照组和慢性阻塞性肺疾病患者的膈肌比股外侧肌具有更高的氧化电位，并且在轻度至中度慢性阻塞性肺疾病中，膈肌的肌肉适应比股外侧肌发生得更早。
The chronology of diaphragm and vastus lateralis adaptation in chronic obstructive pulmonary disease (COPD) has not been studied. The hypothesis of this study was that muscle changes would occur earlier in the diaphragm than in the vastus lateralis in COPD, a finding that would suggest that local factors would be more important than systemic factors in determining the muscle phenotypic expression, at least in mild-to-moderate disease.The adaptation of the vastus lateralis and diaphragm muscles was evaluated in patients with mild-to-moderate COPD and in subjects with normal pulmonary function.In both groups, the oxidative potential and the number of lipofuscin inclusions were higher in the diaphragm than in the vastus lateralis. Compared to control, the diaphragm in COPD had a higher oxidative capacity and a higher proportion of type I fibres, with a reciprocal decrease in type IIA fibres, while there was no difference in diaphragmatic cross sectional areas, capillarisation and lipofuscin inclusions. No significant differences were found in the vastus lateralis from both groups.In conclusion, these data indicate that the diaphragm in controls and in chronic obstructive pulmonary disease has a higher oxidative potential than the vastus lateralis, and that muscle adaptation occurs earlier in the diaphragm than in the vastus lateralis in mild-to-moderate chronic obstructive pulmonary disease.