Fibrinolytic response to acute exercise in patients with peripheral arterial disease.
Fibrinolytic response to acute exercise in patients with peripheral arterial disease.
复制标题
外周动脉疾病患者对急性运动的纤溶反应。
DOI：
10.1097/00005768-200102000-00007
复制
发表时间：
2001
影响因子：
4.1
通讯作者：
Macko,RF
中科院分区：
文献类型：
--
作者：
Womack,CJ;Ivey,FM;Gardner,AW;Macko,RF
目的：运动时组织纤溶酶原激活物（tPA）水平的升高被认为可以预防动脉粥样硬化血栓形成。然而，外周动脉疾病（PAD）患者对重复性间歇性运动的纤溶反应尚不清楚，PAD患者是一个纤溶受损和缺血性事件风险增加的人群。本研究的目的是评估的纤溶反应反复发作的限制性运动在PAD patients.MethodsNine（8男，1女）患者方丹国家II PAD进行了研究。在次极量踏车行走之前、之后即刻、之后30 min和之后60 min，通过留置静脉导管将用于测定tPA和纤溶酶原激活物抑制剂（派-1）的空腹血液样本置于酸化柠檬酸盐溶液中。患者间歇性步行，在65%的最大强度达到了以前的分级运动测试，直到30分钟的exercise.ResultsExercise增加tPA活性的180%（0.5+/-0.16 IU。mL（-1）基线，1.4 ± 1.2 IU。mL（-1）运动后），派-1活性降低40%（20.6+/-5.5 Au. mL（-1）基线，11.8+/-6.2 Au。mL（-1）运动后），而不改变tPA或派-1抗原。值得注意的是，运动后1小时血浆tPA活性水平仍升高80%，而派-1活性仍下降49%。派-1的降低与次极量运动时的氧摄取量（VO（2））呈显著正相关（r=-0.77）（P< 0.05）。
PurposeElevations in tissue plasminogen activator (tPA) are postulated to protect against atherothrombotic events during exercise. However, fibrinolytic response to repetitive bouts of symptom-limited exercise is unknown in peripheral arterial disease (PAD) patients, a population with impaired fibrinolysis and increased risk for ischemic events. The purpose of the present study was to evaluate the fibrinolytic response to repetitive bouts of symptom-limited exercise in PAD patients.MethodsNine (8 male, 1 female) patients with Fontaine State II PAD were studied. Fasting blood samples for determination of tPA and plasminogen activator inhibitor (PAI-1) were obtained into an acidified citrate solution via an indwelling venous catheter before, immediately after, 30 min after, and 60 min after submaximal treadmill walking. Patients walked intermittently at 65% of maximal intensity achieved on a previous graded exercise test until 30 min of exercise was achieved.ResultsExercise increased tPA activity by 180%(0.5+/-0.16 IU. mL (-1) baseline, 1.4+/-1.2 IU. mL (-1) postexercise), and decreased PAI-1 activity by 40%(20.6+/-5.5 AU. mL (-1) baseline, 11.8+/-6.2 AU. mL (-1) postexercise), without changing tPA or PAI-1 antigen. Notably, plasma tPA activity levels 1 h after exercise remained elevated by 80%, whereas PAI-1 activity remained decreased by 49%. The decrease in PAI-1 significantly (P< 0.05) correlated with oxygen uptake (VO (2)) during submaximal exercise (r=-0.77).ConclusionThese findings demonstrate that repetitive bouts of symptom-limited exercise produce a substantial improvement in the fibrinolytic profile of PAD patients, which persists at least 1 h after exercise cessation.