《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (10): 1190-1198.doi: 10.3969/j.issn.1006-9771.2021.10.009
收稿日期:
2019-10-15
修回日期:
2021-09-01
出版日期:
2021-10-25
发布日期:
2021-10-29
通讯作者:
向政
E-mail:2216311@qq.com
作者简介:
刘晓丽(1980-),女,土家族,湖北建始县人,博士,博士后,副教授,主要研究方向:间歇性低氧对人体的影响。
基金资助:
LIU Xiao-li1,Xiangrong SHI2,XIANG Zheng1(),ZHU Huan1
Received:
2019-10-15
Revised:
2021-09-01
Published:
2021-10-25
Online:
2021-10-29
Contact:
XIANG Zheng
E-mail:2216311@qq.com
Supported by:
摘要:
目的 系统综述适度间歇性低氧(IH)对临床相关疾病的康复作用。方法 通过关键词检索和滚雪球方式在PubMed、ScienceDirect数据库、中国知网、万方检索适度IH对临床相关疾病康复作用的相关文献,检索时间2004年至2021年。结果 共获得有效文献27篇,主要集中在适度IH对神经系统、呼吸系统和心血管疾病的作用,对机体代谢的调节和改善运动能力方面的研究。结论 适度IH能改善认知功能,缓解脑缺血性卒中症状,加速脊髓损伤恢复,抗抑郁,降血压,调节机体代谢,改善有氧运动能力,增强呼吸功能,并对冠心病具有康复作用。但应用于临床还需深入研究,特别是IH干预的低氧浓度、每次IH的周期及频率、干预切入时机及整个疗程的时间均需要进一步确定和规范。
中图分类号:
刘晓丽,Xiangrong SHI,向政,朱欢. 适度间歇性低氧对临床相关疾病的康复作用[J]. 《中国康复理论与实践》, 2021, 27(10): 1190-1198.
LIU Xiao-li,Xiangrong SHI,XIANG Zheng,ZHU Huan. Rehabilitation of Moderate Intermittent Hypoxia on Clinical Related Diseases (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(10): 1190-1198.
表1
适度IH在疾病康复应用的文献分类"
类别 | 纳入文献 | 研究对象 | IH干预策略 | 结果 | 效果 |
---|---|---|---|---|---|
改善认知功能障碍 | Zhang等[ | 幼年小鼠 | 16.0%O2,每天4 h,持续3~4周 | 水迷宫和八臂迷宫成绩显著增加,海马中突触增多 | 提高空间学习和记忆能力 |
Manukhina等[ | 阿尔茨海默病小鼠 | 每天模拟海拔4000 m高度环境4 h,持续14 d | 被动回避性条件反射增强,NO代谢产物减少 | 有效阻止氧化应激,减缓神经退行性病变及维持认知功能 | |
Bayer等[ | 64~92岁记忆力减退老人 | 4~7 min 10%~14%O2-2~4 min 30%~40%O2,每次4~8个循环,每周3次,持续5~7周 | DemTect量表测试和画钟试验成绩均显著提高 | 提高老人认知功能 | |
Serebrovska等[ | 轻度认知功能障碍患者 | 5 min 12%O2-3 min常氧,每次4个循环,每周5次,持续3周 | 蒙特利尔认知评估量表测试成绩显著提高,β-淀粉样蛋白表达显著降低 | 改善认知功能,减缓症状发展 | |
Wang等[ | 记忆力减退老人 | 5 min 10%O2-5 min常氧,每次8个循环,每周3次,持续8周 | 大脑氧含量增加,短时记忆能力测试和数字广度测试成绩提高 | 提高短时记忆和注意力 | |
缺血性脑卒中康复 | Tsai等[ | 脑缺血大鼠 | 12%O2,每天4 h,持续7 d | 海马神经元BDNF表达增加,突触素强度和密度增加 | 能够促使海马神经和突触发生,挽救缺血引起的空间学习和记忆障碍 |
抗抑郁 | Rybnikova等[ | 成年大鼠 | 每天模拟5000 m海拔高度环境2 h,持续10 d | 抗抑郁和焦虑效果与抗抑郁药物一致 | 具有抗抑郁和焦虑作用,预防抑郁发作 |
Zhu等[ | 成年大鼠 | 每天模拟5000 m海拔高度4 h,持续14 d | 海马神经发生显著增加 | 潜在治疗抑郁的方法 | |
脊髓损伤康复 | Trumbower等[ | 慢性脊神经损伤患者 | 单次1 min 9%O2-1 min常氧,15个循环 | 足底屈曲力矩和踝关节跖屈电活性显著增加 | 增强慢性脊髓损伤患者运动能力 |
Hayes等[ | 脊髓损伤1年以上患者 | 90 s 9%O2-60 s常氧,15个循环,持续5 d | 显著提高患者步行速度和距离 | 促进患者功能恢复 | |
Navarrete-Opazo等[ | 损伤> 6个月的脊髓损伤患者 | 90 s 9%O2-60 s常氧,15个循环,持续4周 | 10 m步行测试和6 min步行试验显著增强 | 改善患者步行功能 | |
Naidu等[ | 受伤时间< 12个月的脊髓损伤患者 | 90 s 9%O2-60 s常氧,15个循环,持续15 d | 10 m步行测试、6 min步行试验和平衡能力显著增强。 | 患者步行功能得到改善 | |
改善呼吸功能 | Lovett-Barr等[ | 脊髓完全半切大鼠 | 5 min 10%O2-5 min常氧,每次10个周期,持续7 d | 增加大鼠的肺通气量和增强膈肌收缩 | 改善呼吸功能 |
Satriotomo等[ | 脊髓完全半切大鼠 | 5 min 10.5% O2-5 min常氧,每次10个周期,持续7 d | 膈神经长时程易化 | 引起膈神经化学可塑性 | |
缓解COPD症状 | Burtscher等[ | COPD患者 | 3~5 min 12%~15% O2-3~5 min常氧,每天5~9个周期,持续15 d | 显著增加患者压力反射敏感性、高碳酸血症通气反应、时间肺活量和肺活量 | 改善COPD症状 |
对冠心病的康复作用 | del Pilar Valle等[ | 冠心病患者 | 模拟2400 m海拔高度每天持续1 h,14次 | 心肌灌注明显改善,且无心肌损伤现象 | 可能是治疗冠心病的新方法 |
Glazachev等[ | 冠心病患者 | 4~6 min 10%~12% O2-3 min 30%~35%O2,每次5~7个循环,每周3次,持续5周 | 运动能力改善,收缩压和舒张压降低,左心室射血分数提高 | 能够改善运动耐受性,提高生活质量 | |
降血压 | Kong等[ (2014) | 肥胖成年人 | 每周16 h常氧训练+6 h模拟1000~2000 m海拔高度训练,持续4周 | 与每周常氧22 h训练组相比,收缩压和平均动脉压显著下降 | IH环境下训练有利于血压降低 |
Zhang等[ | 健康成年人 | 5~6 min 10% O2-4 min常氧,每次5~10个循环,持续14 d | 增强基线迷走心功能,减弱对缺氧的心动过速反应 | 增强迷走神经功能 | |
Liu等[ (2020) | 健康老人 | 单次5 min 10%O2-5 min常氧循环5个周期 | 收缩压和舒张压平均下降2~6 mmHg | 有降血压作用 | |
Wang 等[ (2020) | 记忆力减退老人 | 5 min 10% O2-5 min常氧,每次8个周期,每周3次,持续8周 | 安静时血压降低5~7 mmHg | 降血压作用 | |
减肥 | Netzer等[ | 肥胖成年人 | 90 min 15%O2,每周3次,持续8周的运动训练 | 较常氧训练组体质量降低更多 | 较好的减肥方法 |
Lippl等[ (2010) | 男性肥胖受试者 | 海拔2650 m高度居住7 d | 体质量显著降低 | 肥胖者在高海拔地区体质量减轻 | |
Kong等[ (2014) | 肥胖成年人 | 每周16 h常氧训练+6 h模拟1000~2000 m海拔高度训练,持续4周 | 与每周常氧22 h训练组相比,体质量降低更多 | IH环境下运动减肥效果更好 | |
Hobbins等[ | 肥胖受试者 | 15 min 13%O2-2 min常氧,每次8个循环,持续2周(低氧时运动,常氧休息) | 体质量和6 min步行测试与常氧训练组相比无显著性差异 | IH环境下运动对体质量影响不显著 | |
改善T2D症状 | Serebrovska 等[ | 前驱糖尿病患者 | 5 min 12%O2-5 min常氧,每次4个循环,每周3次,持续3周 | 血糖水平显著下降 | 有助于预防T2D的发展 |
de Groote等[ | 肥胖青少年 | 每天60 min 15%O2,每周3次,持续6周耐力和抗阻运动 | 增强胰岛素敏感性,降低血糖和甘油三酯水平 | 减轻胰岛素抵抗和降低青少年T2D | |
改善运动能力 | Burtscher等[ | 50~70岁老人 | 3~5 min 10%~14%O2-3 min常氧,每周5次,持续3周 | 峰值耗氧量和血氧饱和度均显著增加 | 提高有氧能力和耐力 |
Bayer等[ (2017) | 64~92岁老人 | 4~7min 10%~14%O2-2~4 min 30%~40%O2,每次4~8个循环,每周3次,持续5~7周 | 6 min步行试验成绩显著提高 | 提高老人有氧运动能力 | |
Bayer等[ (2019) | 64~92岁健康老人 | 4~7 min 10%~14%O2-2~4 min 30%~40%O2,每次4~8个循环,每周3次,持续5~7周 | Tinetti运动试验、起立行走试验、Barthel指数与对照组相比无显著性差异 | 低氧-高氧干预并不能显著增加感知能力和平衡协调性 |
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