健康成人延迟性肌肉酸痛^31P-MR波谱及其与肌酸激酶、酸痛指数相关性分析  

The changes of healthy adults delayed onset muscle soreness 31 P-MR spectroscopy and correlation between serum creatine kinase and soreness index

作　　者：王希海[1] 陈超[2] 卢昊宁 孟帆[1] 李飞[1] 王子文 富聪聪[1] 夏丽莹[1] 富西湖[1] 潘诗农[1] 郭启勇[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004 [2]西安市儿童医院放射科

出　　处：《中华放射学杂志》2014年第1期17-20,共4页Chinese Journal of Radiology

基　　金：国家自然科学基金资助项目（30871211,81271538）;盛京自由研究者基金资助项目（201208）

摘　　要：目的分析健康志愿者股四头肌延迟性肌肉酸痛（DOMS）^31P—MRS影像特征，及其与肌酸激酶（CK）、酸痛指数相关性。方法选取10名健康志愿者。所有受试者运用短距离重复跑运动模式进行训练以获得DOMS模型，且在运动前，运动后即刻、1、2、3、5、7d对右侧股四头肌进行^31P—MRS扫描、血清学CK浓度检查、肌肉酸痛指数评分，分别测量^31P—MRS无机磷酸盐（Pi）、磷酸肌酸（PCr）和三磷酸腺苷（ATP）峰下面积，并计算Pi／PCr、PCr／ATP、Pi／ATP比值。运用重复测量资料的方差分析对各指标不同时间上的变化的特点进行分析。用Spearman秩相关分析对^31P-MRS测量结果与CK值、酸痛指数进行相关性分析。结果10名健康志愿者右侧股四头肌^31P—MRS检查显示Pi峰下面积、Pi／PCr在运动后随时间逐渐增加，在运动后1～2d达到最大值（分别为0．334-0．04、0．27±0．03），两者在时间上有一致性。PCr及ATP峰下面积在运动后即刻较运动前明显下降，在运动后1d逐渐恢复到运动前水平（分别为0．28±0．05、1．22±0．04）。CK在运动后即刻轻度增高，运动后1d血清中CK[（577±223）U／L]明显增高达到峰值，运动后2d[（483±229）U／L]逐渐下降但仍明显高于运动前水平[（86±30）U／L]，运动后7dCK逐渐恢复到运动前水平。Pi峰下面积及Pi／PCr与CK均呈正相关（r值分别为0．631、0．614，P值均〈0．01）。PCr峰下面积、ATP峰下面积与CK值无相关性（，值分别为0．044、0．188，P值均〉0．05）。Pi峰下面积、Pi／PCr、Pi／ATP与酸痛指数相呈正相关（r值分别为0．762、0．758，0．616，P值均〈0．05）。结论^31P—MRS能够有效评估DOMS后骨骼肌代谢产物的变化规律，^31P—MRS与血清学指标、肌肉酸痛指数能够对DOMS进行综合评价，十分有助于为运动训练提供科学的理论依据和指导。Objective To analyse quadriceps metabolic changings in 31 P-MRS of healthy volunteers with delayed onset muscle soreness （DOMS） and its relationship with creatine kinase （CK）, pain index. Methods Ten healthy volunteers, who conducted a motion model to induce DOMS. Serum creatine kinase （CK） concentration, muscle soreness （DOMS）, and 31 P-MRS were taken immediately before and at 0 hours, 1 day ,2 days,3 days,5 days,7 days after exercise to elucidate the extent of muscle damage. 31 P-MRS observation indexes included the peak areas of Pi, PCr, ATP and the ratio of Pi/PCr. Repeated measures ANOVA（ analysis of variance）was used for 31 P-MRS observation indexes of each time. Correlation between serum CK concentration and 31p-MRS observation indexes was assessed with Spearman rank correlation analysis. Results The peak area of Pi, Pi/PCr ratio and CK concentrations gradually increased after exercise,and reached their maximum（0. 33 ±0. 04 and 0. 27 ±0. 03） in 24-48 hours after exercise in time consistency. After exercise,the peak areas of PCr and ATP could be reduced compared with before exercise, 24 h after gradually returned to the pre-exercise leve（0. 28 ±0. 05 and 1.22 ±0. 04）. CK were significantly elevated above baseline for 72 hours post-exercise[ （483 ±229）U/L] ,24 hours after exercise serum CK was significantly increased and reached the peak [ （ 577 ± 223 ） U/L ]. One week after exercise CK gradually returned to pre-exercise level[ （86 ±30）U/L] （P 〉 0. 05 ）. The CK showed significant positive correlations withPi（r =0.631,P 〈0.01） and Pi/PCr（r = 0.614,P 〈0.01）.Respectively, the CK showed no correlation with PCr （ r = 0. 044, P 〉 0. 05 ） and ATP （ r = 0. 188, P 〉 0. 05 ）. The indexes of exercise-induced sore-pain showed positive correlation with Pi （ r = 0. 762, P 〈 0.05 ）, Pi/PCr （ r = 0. 758, P 〈 0.05 ） and Pi/ATP（r =0. 616,P 〈 0. 05）. Conclusions 31 P-MRS could effectively assess skeletal muscle metabolites after DOMS

关 键 词：肌疲劳 肌酸激酶 疼痛测定 磁共振波谱学 

分 类 号：R685[医药卫生—骨科学] R445.2[医药卫生—外科学]