Effects of exercise intensity compared to albuterol in individuals with cystic fibrosis.
Effects of exercise intensity compared to albuterol in individuals with cystic fibrosis.
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与沙丁胺醇相比，运动强度对囊性纤维化患者的影响。
DOI：
10.1016/j.rmed.2014.12.002
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发表时间：
2015
影响因子：
4.3
通讯作者：
Snyder,EricM
中科院分区：
文献类型：
--
作者：
Wheatley,CourtneyM;Baker,SarahE;Morgan,MaryA;Martinez,MarinaG;Morgan,WayneJ;Wong,EricC;Karpen,StephenR;Snyder,EricM
尽管运动是囊性纤维化患者治疗的重要组成部分，但由于有限的治疗时间和许多囊性纤维症患者认为运动不如药物治疗的观点，它并不是优先考虑的。我们试图比较运动和他们开出的支气管扩张剂沙丁胺醇的治疗效果。方法CF(n=14)和健康(n=416)受试者完成了三次访问，一次VO2max试验的基线筛查和两次治疗访问。在两次治疗访问中，受试者在给药后基线、60和110分钟，或者在基线和三次单独的15分钟低强度、中等强度和剧烈运动的中点(分别为最大工作量的25%、50%和65%)完成肺活量和肺一氧化氮弥散量(DLNO)动作。结果与服用沙丁胺醇后110分钟运动后相比，中度运动组DLNO增加了一倍(39%±10.8%比15%±16.6%)，支气管扩张水平相似(23%变化)。与沙丁胺醇对沙丁胺醇的反应相比，运动期间FVC降低(−309±6.66 mL，中等运动时)，FEV1增加幅度减弱(103.00±2.39 mLvs236±2.58 mLvs沙丁胺醇)。小强度运动使肾上腺素(EPI)释放增加39%，中等强度运动增加72%，大强度运动增加144%，但与健康受试者相比，这种增加有所减弱。结论小强度运动使EPI增加不到50%，大强度运动使气流受到限制，是CF患者的最佳运动强度。虽然这种有益效果的持续时间尚不确定，但与沙丁胺醇相比，运动可以促进气体扩散和类似的支气管扩张方面的更大改善。
BackgroundAlthough exercise is a vital component of the therapy prescribed to individuals with cystic fibrosis (CF), it is not a priority due to a finite amount of treatment time and the view that exercise is not as beneficial as pharmacological treatments by many individuals with CF. We sought to compare the therapeutic benefits of exercise and their prescribed bronchodilator albuterol.MethodsCF (n= 14) and healthy (n= 16) subjects completed three visits, a baseline screening with VO2max test and two treatment visits. On the two treatment visits, subjects completed spirometry and diffusing capacity of the lungs for nitric oxide (DLNO) maneuvers either at baseline, 60, and 110 min post-albuterol administration, or at baseline and the midway point of three separate 15 min exercise bouts at low, moderate and vigorous intensity (25, 50 and 65% of the maximum workload, respectively).ResultsWith moderate exercise the increase in DLNO was double (39 ± 8 vs 15 ± 6% change) and the level of bronchodilation similar (23% change) when compared to 110 min post-albuterol in individuals with CF. During exercise FVC became reduced (−309 ± 66 mL with moderate exercise) and the increase in FEV1was attenuated (103 ± 39 vs 236 ± 58 mL, exercise vs. albuterol) when compared with the response to albuterol in individuals with CF. Epinephrine (EPI) release increased 39, 72 and 144% change with low, moderate and vigorous intensity exercise respectively for individuals with CF, but this increase was blunted when compared to healthy subjects.ConclusionOur results suggest that moderate intensity exercise is the optimal intensity for individuals with CF, as low intensity exercise increases EPI less than 50% and vigorous intensity exercise is over taxing, such that airflow can be restricted. Although the duration of the beneficial effect is uncertain, exercise can promote greater improvements in gas diffusion and comparable bronchodilation when compared to albuterol.