血流限制训练干预老年肌少症:生物学机制和应用方案建议  

Blood flow restriction training interventions for sarcopenia in older adults:biological mechanisms and proposed application protocols

作　　者：孔健达 解瑛傲 陈世娟 朱磊[1] Kong Jianda;Xie Yingao;Chen Shijuan;Zhu Lei(School of Sports Science,Qufu Normal University,Qufu 273100,Shandong Province,China;Affiliated Hospital of Jining Medical University,Jining 272000,Shandong Province,China;School of Sports Science,Tianjin Normal University,Tianjin 300000,China)

机构地区：[1]曲阜师范大学体育科学学院,山东省曲阜市273100 [2]济宁医学院附属医院,山东省济宁市272000 [3]天津师范大学体育科学学院,天津市300000

出　　处：《中国组织工程研究》2024年第23期3743-3750,共8页Chinese Journal of Tissue Engineering Research

基　　金：山东省专业学位研究生教学案例库项目(SDYAL20103),项目负责人:朱磊。

摘　　要：背景:肌少症是一种慢性病,会导致力量丧失和功能下降,增加老年人虚弱、残疾、跌倒和死亡风险。血流限制训练可以有效治疗肌少症,但还缺乏对其优缺点、生物学机制和应用方案的全面回顾。目的:通过回顾血流限制训练干预肌少症的优势、局限性和生物学机制,并基于当前已发表的证据给予应用方案建议。方法:检索各大数据库建库至2023年2月发表的文献。英文检索词:blood flow restriction training、KAATSU、elderly、sarcopenia、muscle等;中文检索词:血流限制训练、加压训练、老年人、肌少症和肌肉等。对纳入的82篇文献进行整理和分析。结果与结论:①血流限制训练作为干预肌少症的一种方法,在外周肌群中有一定的效果,但其应用范围存在局限性,血流限制训练具备较高的可操作性和安全性,并能够提高肌肉力量和身体表现,但血流限制训练亦存在潜在风险,尤其证据报告了其对骨骼肌、心血管和内皮细胞等的不良事件,故需在科学指导下进行,并需进一步研究验证其对肌少症患者的效果。②血流限制训练干预肌少症的生物学机制可能包括:增加肌肉反应性充血导致肌肉肥大、改善肌肉蛋白合成能力、诱导代谢应激适应、促进骨骼肌生长和修复、激活血管内皮生长因子信号通路促进血管生成、促进卫星细胞增殖,但这些机制的具体作用和联合作用需要更深入的研究来确定。③血流限制训练干预肌少症主要受训练和袖带的影响,为避免出现不良事件,建议训练负荷20%-50%1RM,重复次数20-75次,训练频率每周两三次,组间间隔30-60 s,上肢训练使用较小尺寸的袖带且加压值≤140 mmHg,下肢训练使用较大尺寸的袖带且加压值≤180 mmHg,通常选择完全闭塞动脉血流压力值的50%-80%,但老年人血流限制训练频度和组间间隔的研究还需更多探讨,同时袖带加压值的最适选择亦需要进一步BACKGROUND:Sarcopenia is a chronic condition that leads to strength loss and functional decline,increasing the risk of frailty,disability,falls,and death in older adults.Blood flow restriction training can be effective in the treatment of sarcopenia,but a comprehensive review of its advantages,disadvantages,biological mechanisms,and application options is lacking.OBJECTIVE:To review the advantages,limitations,and biological mechanisms of blood flow restriction training interventions for sarcopenia and to give recommendations for application protocols based on current published evidence.METHODS:A search of major databases was conducted for literature published in the time frame up to February 2023.The search terms were“blood flow restriction training,KAATSU,elderly,sarcopenia,muscle”in English and Chinese.Finally,82 included papers were compiled and analyzed.RESULTS AND CONCLUSION:Blood flow restriction training as an intervention for sarcopenia has been effective in peripheral muscle groups,but there are limitations in its application.Blood flow restriction training is highly operational and safe.This training can improve muscle strength and physical performance,but there are potential risks,including adverse events on skeletal muscle,cardiovascular and endothelial cells.Therefore,blood flow restriction training needs to be performed under scientific guidance and further studies are needed to verify its efficacy in patients with sarcopenia.The biological mechanisms of blood flow restriction training intervention in sarcopenia may include:increasing muscle hypertrophy due to reactive muscle congestion,improving muscle protein synthesis capacity,inducing metabolic stress adaptation,promoting skeletal muscle growth and repair,activating vascular endothelial growth factor signaling pathway to promote angiogenesis,and promoting satellite cell proliferation.However,these specific roles and combined effects of these mechanisms need to be determined by more in-depth studies.Blood flow restriction training interventio

关 键 词：血流限制训练 加压袖带 抗阻训练 肌少症 骨骼肌 生物学机制 运动处方 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R496