乙酰唑胺对高原COPD患者运动表现的影响:随机对照试验。

IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM
ERJ Open Research Pub Date : 2025-01-20 eCollection Date: 2025-01-01 DOI:10.1183/23120541.00767-2024
Roman F Kind, Michael Furian, Aline Buergin, Philipp M Scheiwiller, Laura Mayer, Simon R Schneider, Mona Lichtblau, Lara Muralt, Maamed Mademilov, Talant M Sooronbaev, Silvia Ulrich, Konrad E Bloch
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引用次数: 0

摘要

背景:在COPD患者中,用乙酰唑胺进行预防性治疗可减少高原旅行对健康的不良影响。我们调查了预防性乙酰唑胺治疗是否会改变去高海拔地区的COPD患者的运动表现。方法:在这项随机、双盲试验中,患有COPD的低地人,预计1秒用力呼气量(FEV1)为40-80%,在上升前24小时开始接受乙酰唑胺(每24小时375 mg)或安慰剂治疗,并保持在3100米。患者在服用研究药物前和到达3100 m后4小时内分别在760 m处进行渐进式自行车运动至精疲力竭。主要终点是最大功率输出(Wmax)。结果:103例患者(32名女性),平均±sd年龄57.2±8.1岁,预测FEV1 66±11%,纳入方案分析。53例接受乙酰唑胺治疗的患者,760 m和3100 m时的Wmax和氧摄取(V'O2 max)分别为105±27和91±25 W, 18.0±4.8和15.5±3.7 mL·min-1·kg-1(50例接受安慰剂治疗的患者的pmax和V'O2 max分别为107±34和97±28 W, 18.9±6.0和17.2±5.0 mL·min-1·kg-1 (pmax变化为-3.0 W(-8.7至+2.7,p=0.305), V'O2 max变化为-0.8 mL·min-1·kg-1(-2.1至+0.5,p=0.213)。乙酰唑胺可减轻海拔引起的pao2下降0.7 kPa (0.1 ~ 1.3, P =0.016)。在3100 m时,呼吸交换比≤1时,乙酰唑胺组的最大工作速率比安慰剂组高10.1 W (4.0 ~ 16.2, p=0.022)。结论:在低海拔地区COPD患者中,乙酰唑胺预防治疗并不能改变海拔引起的最大工作速率降低。然而,与安慰剂相比,乙酰唑胺增强了动脉氧合和亚极限、中等强度的工作能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of acetazolamide on exercise performance in patients with COPD going to high altitude: randomised controlled trial.

Background: In patients with COPD, preventive treatment with acetazolamide reduces adverse health effects during altitude travel. We investigated whether preventive acetazolamide treatment modifies exercise performance in COPD patients going to high altitude.

Methods: In this randomised, double-blind trial, lowlanders with COPD, forced expiratory volume in 1 s (FEV1) 40-80% predicted, were assigned to acetazolamide (375 mg per 24 h) or placebo treatment starting 24 h before ascent and while staying at 3100 m. Patients performed progressive cycling exercise to exhaustion at 760 m, before taking the study drug, and within 4 h after arrival at 3100 m. The primary outcome was the maximal power output (Wmax).

Results: 103 patients (32 women), mean±sd age 57.2±8.1 years, FEV1 66±11% predicted, were included in per-protocol analyses. In 53 patients receiving acetazolamide, Wmax and oxygen uptake (V'O2 max) at 760 m and 3100 m were 105±27 and 91±25 W, and 18.0±4.8 and 15.5±3.7 mL·min-1·kg-1 (p<0.001, both changes). Corresponding Wmax and V'O2 max in 50 patients receiving placebo were 107±34 and 97±28 W, and 18.9±6.0 and 17.2±5.0 mL·min-1·kg-1 (p<0.001, both changes). Between-group differences (95% CI) in altitude-induced Wmax changes were -3.0 W (-8.7 to +2.7, p=0.305) and in V'O2 max changes were -0.8 mL·min-1·kg-1 (-2.1 to +0.5, p=0.213). Acetazolamide mitigated the altitude-induced reduction of P aO2 by 0.7 kPa (0.1 to 1.3, p=0.016). At 3100 m, maximal work rate with respiratory exchange ratio ≤1 was greater with acetazolamide than with placebo by 10.1 W (4.0 to 16.2, p=0.022).

Conclusions: In lowlanders with COPD, preventive treatment with acetazolamide did not modify the altitude-induced reduction in maximal work rate. However, acetazolamide enhanced arterial oxygenation and submaximal, moderate-intensity work capacity compared with placebo.

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来源期刊
ERJ Open Research
ERJ Open Research Medicine-Pulmonary and Respiratory Medicine
CiteScore
6.20
自引率
4.30%
发文量
273
审稿时长
8 weeks
期刊介绍: ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.
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