Acute effect of oral steroids on muscle function in chronic obstructive pulmonary disease
Acute effect of oral steroids on muscle function in chronic obstructive pulmonary disease
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DOI：
10.1183/09031936.04.00139003
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发表时间：
2004-07-01
影响因子：
24.3
通讯作者：
Polkey, MI
中科院分区：
文献类型：
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作者：
Hopkinson, NS;Man, WDC;Polkey, MI
前瞻性数据支持的假设，皮质类固醇激素是一个重要的原因，肌无力的慢性阻塞性肺疾病（COPD）患者是lacked. Authors研究呼吸和股四头肌功能，使用意志技术和磁神经刺激，以及测量代谢参数，在增量踏车测力计，在25个稳定的COPD患者。一秒钟用力呼气量是37.6 +/-21.4%的预测值，在2周的o.d.疗程前后。泼尼松龙30 mg. 15名对照组患者的股四头肌力量也进行了两次评估，只有两名患者符合英国胸科协会对类固醇反应性的定义。双侧前外侧磁刺激膈神经引起的嗅跨膜压（前：96.8 +/- 19.7 cmH（2）O;后：98.6 +/- 22.4 cmH（2）O）或抽搐跨膜压（前：16.8 +/- 9.1 cmH（2）O;后：17.9 +/- 10 cmH（2）O）均无变化。类固醇组（治疗前：9.5+/-3.1 kg;治疗后：8.9+/-3.7 kg）或对照患者（治疗前：8.1+/-2.7 kg;治疗后：7.9+/-2.2 kg）的四头肌抽搐力没有显着变化。有没有任何变化，无论是峰值或isotime代谢和代谢参数在exercise.In结论，在稳定的慢性阻塞性肺疾病患者，2周的过程中，每天30毫克泼尼松龙不会导致显着的骨骼肌功能障碍或改变代谢参数在运动过程中。
Prospective data to support the hypothesis that corticosteroids; are a significant cause of muscle weakness in patients with chronic obstructive pulmonary disease (COPD) are lacking.The authors studied respiratory and quadriceps muscle function, using both volitional techniques and magnetic nerve stimulation, as well as measuring metabolic parameters during incremental cycle ergometry, in 25 stable COPD patients. The forced expiratory volume in one second was 37.6 +/- 21.4 % predicted, before and after a 2-week course of o.d. prednisolone 30 mg. Quadriceps strength was also assessed in 15 control patients on two occasions.Only two patients met the British Thoracic Society definition of steroid responsiveness. There was no change either in sniff transdiaphragmatic pressure (pre: 96.8 +/- 19.7 cmH(2)O; post: 98.6 +/- 22.4 cmH(2)O) or in twitch transdiaphragmatic pressure elicited by bilateral anterolateral magnetic phrenic-nerve stimulation (pre: 16.8 +/- 9.1 cmH(2)O; Post: 17.9 +/- 10 cmH(2)O). Quadriceps twitch force did not change significantly either in the steroid group (pre: 9.5+/-3.1 kg; post: 8.9+/-3.7 kg) or in the control patients (pre: 8.1+/-2.7 kg; post: 7.9+/-2.2 kg). There were no changes in either peak or isotime ventilatory and metabolic parameters during exercise.In conclusion, in stable patients with chronic obstructive pulmonary disease, a 2-week course of 30 mg prednisolone daily does not cause significant skeletal muscle dysfunction or alter metabolic parameters during exercise.