抗肿瘤坏死因子-α治疗
对强直性脊柱炎患者运动能力
影响的前瞻性临床研究
背景本研究旨在找出抗肿瘤坏死因子-α疗法对强直性脊柱炎患者的心肺耐力和运动能力的可能影响。
方法招募符合纽约修订标准的，疾病活动度的28名强直性脊柱炎患者和同等数量的健康者作为对照组。通过心肺运动试验记录受试者抗肿瘤坏死因子-α治疗开始前和开始后4个月的体力工作容量和有氧运动能力。
结果患者的平均年龄为37±9.1岁，平均病程为8.9±7.6年。和健康组相比，强直性脊柱炎患者有氧运动能力显著偏低(峰值摄氧量:21.2±5.5vs.27.2±6.6ml/kg/min,P=0.)，最大能量输出明显偏低(.4±34.8vs.±39.8W,P=0.0)，运动持续时间明显偏低(16.3±2.6vs.19.6±2.9min,P=0.0)。4个月后重测时，患者的有氧运动能力、最大能量输出和运动持续时间都有显著改善。
结论研究结果表明，除炎症指标和生活质量指数外，即使是短期抗肿瘤坏死因子-α治疗也能使心肺健康状态得到显著改善，客观指标为峰值摄氧量、最大能量输出和运动持续时间。
原文Aprospectiveclinicalinvestigationoftheeffectsofanti-TNFalphatherapyonexercisecapacityinpatientswithankylosingspondylitis
Background
Thepurposeofthisstudywastoinvestigatepossibleeffectsofanti-TNFalphatherapyoncardiorespiratoryfitnessandphysicalfunctionalcapacityofpatientswithankylosingspondylitis(AS).
Methods
Twenty-eightASpatientsmeetingthemodifiedNewYorkcriteriawithactivediseasestateandanequivalentnumberofhealthyindividualsasthecontrolwereprospectivelyenrolled.Physicalworkingcapacityandaerobicexercisecapacityoftheparticipantsweredeterminedbyusingcardiopulmonaryexercisetests,performedbeforeand4monthsafterinitiationofanti-TNFalphatherapy.
Results
Themeanageofthepatientswas37±9.1years,andmeandurationofdiseasewas8.9±7.6years.PatientswithASexhibitedsignificantlyloweraerobicexercisecapacity(VO2peak:21.2±5.5vs.27.2±6.6ml/kg/min,P=0.),maximumpoweroutput(.4±34.8vs.±39.8W,P=0.0),andexerciseduration(16.3±2.6vs.19.6±2.9min,P=0.0)thanthehealthycontrols.Whenpatientswerereevaluatedafter4monthsofanti-TNFalphatherapy,significantimprovementwasobtainedinpatients’aerobiccapacity,maximumpoweroutput,andexerciseduration.
Conclusion
Resultsfromthisstudyindicatethatinadditiontoinflammatoryparametersandqualityoflifeindex,evenshort-termanti-TNFalphatherapyresultsinsignificantimprovementincardiopulmonaryhealthstatusasobjectivelyreflectedbypeakVO2,maximumworkrate,andexerciseduration.
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