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運動對阻塞型睡眠呼吸中止症引發心臟功能損傷之影響:鈉氫離子交換蛋白的角色

The Effect of Exercise on Cardiac Damage Induced by Obstructive Sleep Apnoea: The Role of Sodium Hydrogen Exchanger

摘要


目前阻塞型睡眠呼吸中止症在公共衛生上被視為是一個重大的健康問題,因此病症在夜間造成之間歇性低氧的現象,引起心肌自由基生成量上升及血液中發炎物質增加,導致心肌發炎及纖維化,造成心臟功能損傷。雖然運動對阻塞型睡眠呼吸中止症具有正面的助益,但鈉氫離子交換蛋白在運動影響間歇性低氧造成心肌損傷中的角色,目前仍不清楚。從回顧的文獻中得知,運動提升心臟保護功能降低間歇性低氧造成心肌損傷,其原因可能為運動促進心肌鈉氫離子交換蛋白1的調節功能,避免間歇性低氧引起鈉氫離子交換蛋白1過度活化或功能受損,此結果將提供未來探討阻塞型睡眠呼吸中止症之預防與治療策略的一個重要的研究方向。

關鍵字

間歇性低氧 氧化 心肌 纖維化 發炎

並列摘要


Obstructive sleep apnoea (OSA) has been recognized as a significant health problem in the public health. OSA is recurrent obstruction of the upper airway leading to intermittent hypoxia (IH) during sleep. IH may cause increased levels of oxidative stress, leading to cardiac inflammation and cardiac fibrosis, resulting in cardiac dysfunction. Although exercise provides beneficial effects on adjuvant therapy for OSA, whether the sodium-hydrogen exchanger-1 (NHE-1) plays a role in that exercise prevents IH-induced cardiac fibrosis is unclear. Therefore, the purpose of this study is to investigate the role of NHE-1 and its mechanism in that exercise affects the cardiac fibrosis in patients with OSA by literature review. This study suggests that exercise may provide potent cardioprotective effects by attenuating IH-induced cardiac fibrosis, resulting from that exercise enhances the regulation of NHE-1 preventing IH-induced NHE-1 hyperactivity. These results also provide an important future prospect to investigate the prevention and therapeutic strategies for patients with OSA.

參考文獻


楊昆達、黃森芳、涂瑋嘉、林宏逸、陳聰毅(2014)。單次運動對間歇性低氧誘發心肌微管相關蛋白1 輕鏈3-II 的影響。體育學報。47(4),489-502。
Chen, Y., C.,Yang, K. T.,Shen, Y. J.,Cheng, C. F.,Tu, W. C.,Chen, T. I.(2015).Role of sodium-hydrogen exchanger-1 (NHE-1) in the effect of exercise on intermittent hypoxia-induced left ventricular dysfunction.Chinese Journal of Physiology.58(4)
Chen, Y., C.,Yang, K. T.,Shen, Y. J.,Cheng, C. F.,Tu, W. C.,Chen, T. I.(2015).Role of sodium-hydrogen exchanger-1 (NHE-1) in the effect of exercise on intermittent hypoxia-induced left ventricular dysfunction.Chinese Journal of Physiology.58(4)
Lin, Y. M.,Huang, S. K.,Wang, H. F.,Chen, L. M.,Tsai, F. J.,Hsu, H. H.,Lee, S. D.(2008).Short-term versus long-term intermittent hypobaric hypoxia on cardiac fibrosis and Fas death receptor dependent apoptotic pathway in rat hearts.The Chinese Journal of Physiology.51(5),308-316.
Ares-Carrasco, S.,Picatoste, B.,Benito-Martin, A.,Zubiri, I.,Sanz, A. B.,Sanchez-Nino, M. D.,Lorenzo, O.(2009).Myocardial fibrosis and apoptosis, but not inflammation, are present in long-term experimental diabetes.American Journal of Physiology. Heart and Circulatory Physiology.297(6),H2109-2119.

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