Prediction of exacerbation onset in chronic obstructive pulmonary disease patients

The objective of this study was to develop an algorithm for prediction of exacerbation onset in Chronic Obstructive Pulmonary Disease (COPD) patients based on continuous self-monitoring of physiological parameters from telehome-care monitoring. 151 physiological parameters of COPD patients were monitored on a daily/weekly basis for up to 2 years. Data were segmented in 30-day periods leading up to an exacerbation (exacerbation episode) and starting from a 14-day recovery period post-exacerbation (control episode) and tested in 6 intervals to predict exacerbation onset using k-nearest neighbour (k?=?1, 3, 5). A classifier with sensitivity of 73%, specificity of 74%, positive predictive value of 69%, negative predictive value of 78% and an accuracy of 74% was achieved using data intervals consisting of 5 days. Intelligent processing of physiological recordings have potential for predicting exacerbation onset.     

Systemic inflammation in peripheral arterial disease with or without coexistent chronic obstructive pulmonary disease: analysis of selected markers

Introduction

Low-grade systemic inflammation plays an important role in the pathogenesis and natural history of chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD). The aim of the study was to analyze plasma concentrations of selected markers of inflammation in patients suffering from PAD with or without coexistent COPD.

Material and methods

Thirty patients (6 women) with advanced PAD (at least IIb stage according to Fontaine scale) hospitalized due to critical limb ischemia were examined. In all patients spirometry was performed to confirm or exclude COPD. Plasma concentration of IL-6, IL-8 and TNF-α was measured using ELISA method. Statistical analysis was performed according to COPD status and according to smoking status independently.

Results

In the whole group of patients with PAD, COPD was recognized in 14 cases (for the first time in 10 cases). All patients were smokers (46.7% current, 53.3% ex-smokers). We found a significant correlation between FEV1%N (percent of norm of first second expiratory volume) and the number of years of smoking (r = –0.39; p < 0.05). We found similar concentrations of IL-6 (2.54 pg/ml vs. 2.31 pg/ml), IL-8 (8.55 pg/ml vs. 8.14 pg/ml, TNF-α (0.72 pg/ml vs. 1.75 pg/ml) in the COPD(+) group in comparison to the COPD(–) group (differences were not significant). We observed significant positive correlations (p < 0.05) between concentrations of measured markers and significant negative correlations between pain free walking distance and these markers.

Conclusions

Our study confirmed coexistence of PAD with COPD. The character of inflammation is similar in these smoking-related diseases     

Interleukin-1B-31T/C promoter polymorphism and chronic obstructive pulmonary disease risk: a meta-analysis

Introduction

The role of interleukin (IL)-1β –31T/C promoter polymorphism in the pathogenesis of chronic obstructive pulmonary disease (COPD) has been studied with inconsistent results. This meta-analysis was performed to assess the association of IL-1β –31T/C promoter polymorphism with COPD susceptibility.

Material and methods

Published case-control studies from PubMed and China National Knowledge Infrastructure (CNKI) databases were retrieved. Data were extracted and pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated.

Results

Six case-control studies were included in this meta-analysis. The pooled effect size showed that IL-1β -31T/C was significantly associated with COPD susceptibility in an overdominant genetic model (CC+TT vs. TC, OR: 0.77, 95% CI: 0.63–0.94), indicating that homozygotes (CC and TT) had a decreased risk for COPD compared with heterozygotes (TC). In the subgroup analysis by ethnicity, the results indicated that IL-1β –31T/C was significantly correlated with COPD susceptibility in Asians (overdominant model, OR: 0.75, 95% CI: 0.61–0.93), further suggesting a protective role of IL-1β –31T/C in COPD pathogenesis in Asians. Moreover, after excluding the study without Hardy-Weinberg equilibrium, the pooled results were robust and no publication bias was found in this study.

Conclusions

This meta-analysis suggests that IL-1β –31T/C promoter polymorphism confers protection against COPD in Asians.     

重症慢性阻塞性肺疾病急性加重期下呼吸道感染病原菌及其耐药性分析

目的:了解重症慢性阻塞性肺疾病急性加重期(AECOPD)患者下呼吸道感染病原菌的特点及耐药情况,指导临床合理用药。方法:取我院2007年10月~2010年9月住院的189例重症AECOPD患者合格痰标本及防污染毛刷刷取的气管内分泌物标本进行细菌培养、鉴定及药敏试验。结果:共分离病原菌147株,其中以革兰阴性杆菌占首位,达64.6%,依次为铜绿假单胞菌、不动杆菌、大肠埃希菌和阴沟肠杆菌。其次是革兰阳性球菌,占21.8%。真菌占13.6%,以白念珠菌检出率最高。药敏结果显示革兰阴性杆菌对第三代头孢菌素耐药严重,对哌拉西林-他唑巴坦、碳青霉烯类抗生素较敏感;革兰阳性球菌对青霉素、克林霉素、红霉素耐药率高,未发现对万古霉素耐药。结论:重症AECOPD患者下呼吸道感染病原菌以革兰阴性杆菌为主,且耐药现象明显,二重感染逐年增加,且占有较大比重。临床AECOPD患者选用抗生素治疗时应重视细菌培养及药敏试验,减少不合理用药,减少耐药菌株与二重感染产生。     

慢性阻塞性肺疾病急性加重患者呼吸道病毒的检测分析

目的 探讨呼吸道病毒感染与慢性阻塞性肺疾病急性加重(AECOPD)的相关性.方法 随机选择140例慢性阻塞性肺疾病急性加重(AECOPD)患者,60例健康老年志愿者为对照组,分别检测呼吸道合胞病毒(RSV)、单纯疱疹病毒(HSV)、腺病毒(ADV)、巨细胞病毒(CMV)、副流感病毒(PIV)、流感病毒A/B(FluA/B)特异性抗体IgM水平,对组间阳性率进行比较.结果 AECOPD组患者中IgM阳性率依次为RSV＞PIV＞ FluA/B＞CMV＞ADV＞ HSV.AECOPD组与对照组各病毒抗体阳性率比较差异有统计学意义(P＜0.05).结论 病毒感染是AECOPD重要因素,病毒感染参与了AECOPD病情的进展过程,在呼吸道病毒流行的季节应做好预防工作.     

外周血中性粒细胞/淋巴细胞比值在慢性阻塞性肺病相关肺动脉高压患者中的预后价值

目的：探讨外周血中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)对慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)相关肺动脉高压患者预后的评判价值。方法：选择2013年1月至2014年3月收治入上海交通大学医学院附属新华医院急诊科的200例COPD相关肺动脉高压(pulmonary hypertension,PH)患者为研究对象,对其进行至少2年的生存随访,随访终点为全因死亡,按照生存情况分为生存组和死亡组;记录各组入院24 h的一般临床资料,血常规[C反应蛋白(C-reactive protein,CRP)、中性粒细胞计数(neutrophils count,NEU)及淋巴细胞计数(lymphocyte count,LYM)并计算两者间比值(NLR)]、肌酐、尿素氮、胆红素、WHO肺动脉高压功能分级、肺动脉收缩压等;绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析NLR预测患者预后的临床价值;并以Kaplan-Meier法绘制观察指标不同水平下的生存曲线,进行生存分析。COX回归分析各指标提示预后的价值。结果：死亡组患者NLR,CRP,WHO肺动脉高压功能分级、肺动脉收缩压、尿素氮、肌酐、中性粒细胞计数高于生存组,淋巴细胞计数低于生存组,差异均具有统计学意义(P<0.05)。根据ROC曲线分析,NLR的ROC曲线下面积(AUC)为0.720(P<0.01),高于肌酐(AUC=0.716)、中性粒细胞计数(AUC=0.655)、肺动脉收缩压(AUC=0.652)及CRP(AUC=0.643)。当NLR截断值为4.7时,其灵敏度为74.2%,特异度为72.0%。Kaplan-Meier生存曲线分析显示,NLR值水平较高组预后明显差于水平较低组(P<0.01)。单因素Cox回归分析提示NLR是提示患者不良预后的危险因素,多因素Cox回归分析(P>0.05)。结论：NLR水平与COPD相关肺动脉高压患者临床预后呈明显相关;NLR水平越高则提示病情较重,预后较差。     

Persistence and genetic adaptation of Pseudomonas aeruginosa in patients with chronic obstructive pulmonary disease

ObjectivesIt is unclear whether recurrent sputum culture with Pseudomonas aeruginosa from patients with chronic obstructive pulmonary disease (COPD) is caused by intermittent airway carriage by different P. aeruginosa lineages or persistent carriage by the same lineage, and whether lineages genetically adapt during carriage.MethodsWhole-genome sequencing was performed for P. aeruginosa isolates sampled longitudinally from sputum cultures in patients with COPD who were enrolled in an ongoing randomized controlled trial (clinicaltrials.gov: NCT03262142).ResultsA total of 153 P. aeruginosa isolates were sequenced for 23 patients during 365 days of follow-up. Recurrent presence of P. aeruginosa was seen in 19 patients (83%) and was caused by persistence of the same clonal lineage in all but one patient. We identified 38 genes mutated in parallel in two or more lineages, suggesting positive selection for adaptive mutations. Mutational enrichment analysis revealed genes important in antibiotic resistance and chronic infections to be more frequently mutated.DiscussionRecurrent P. aeruginosa was common and carried for a prolonged time after initial detection in the airways of patients with COPD. Recurrence was caused by persistence of the same clonal lineage and was associated with genetic adaptation. Trial data on possible clinical benefits of attempting antibiotic eradication of P. aeruginosa in COPD are warranted.     

胸腺五肽辅助治疗慢性阻塞性肺病的疗效观察

目的观察胸腺五肽辅助治疗慢性阻塞性肺病(COPD)的疗效。方法将78例COPD患者随机分为2组,对照组给予常规治疗,治疗组加用胸腺五肽,观察比较2组患者症状体征缓解时间、平均住院时间以及3个月内再入院率。结果治疗组症状体征缓解时间、平均住院时间均较对照组显著缩短(P<0.05),治疗组3个月内再入院率较对照组显著降低(P<0.05)。结论胸腺五肽可增强COPD患者的免疫功能,缩短平均住院时间,降低再发风险,提高患者生活质量。     

结核性胸膜炎合并慢性阻塞性肺疾病患者免疫功能的变化及意义

目的 通过观察T淋巴细胞亚群、B细胞、NK细胞活性来探讨结核性胸膜炎合并慢性阻塞性肺疾病(COPD)患者免疫功能变化.方法 采用流式细胞术分别测定45例结核性胸膜炎合并COPD患者(研究组)、45例COPD患者(COPD对照组)和45例健康体检者(健康对照组)外周血T淋巴细胞亚群、B细胞和NK细胞水平.结果 研究组CD3+、CD4+、CD4+/CD8+、B细胞和NK细胞表达率降低,与健康对照组差异有统计学意义(P ＜0.05);COPD对照组CD3+、CD4+、CD4+/CD8+、B细胞和NK细胞表达率与健康对照组差异有统计学意义(P＜0.05);研究组与COPD对照组的差异无统计学意义.结论 结核性胸膜炎合并COPD患者免疫功能明显低于正常健康人群,增强免疫治疗非常必要.     

Severe chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) exacts a heavy toll on society, yet its prevention, diagnosis and treatment receives inadequate attention from both the medical community and from society at large. Guidelines released in 2001 from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) are aimed at redressing this inequity. In this review, we integrate information from the GOLD guidelines with recent updates on the prevention, treatment and management as related specifically to the most severe form of this disease. In order to help distinguish COPD from other disorders that may mimic or confound its treatment, we place particular emphasis on the definition, underlying pathophysiology and diagnosis of COPD. In addition, we discuss future directions in pharmacotherapy.     

基于核磁共振技术的人体肺功能障碍疾病血样的代谢组特征

慢性阻塞性肺病（Chronic Obstructive Pulmonary Disease, COPD）的临床诊断方法主要为肺功能检查和胸部影像学检查（如MRI和CT等）,但它们检测的灵敏性和重复性较差。本研究拟通过应用核磁共振氢谱技术检测50例健康者和42例COPD患者血液中一些代谢物的变化,以期在分子水平寻求诊断COPD的生物标志物,以帮助COPD患者进行早期筛查。研究结果发现,在牛磺酸区（δ 3.34~3.30）、谷氨酸区（δ 2.50~2.26）和脂类区（δ 0.90~0.86）等5区域代谢物浓度,以及牛磺酸和谷氨酸区与葡萄糖浓度比值在健康组和COPD组间有显著性差异,此将为COPD诊断标志物的研究提供帮助。     

血清降钙素原水平分级在慢性阻塞性肺疾病急性加重期的临床价值探讨

目的:探讨血清降钙素原(Procalcitonin,PCT)水平分级在慢性阻塞性肺疾病急性加重期(Acute exacerbation ofchronic obstructive pulmonary disease,AECOPD)的临床价值。方法:以48例进入本研究的慢性阻塞性肺疾病急性加重期患者作为病例组,另随机抽取同期住院的45例普通肺炎患者作为对照组。两组均于24h内测定血清PCT、血常规、C反应蛋白(C-reactiveprotein,CRP)及进行痰培养,同时将病例组按PCT水平分为<0.05、0.05～1.0、1.0～10、10～20、≥20ng.ml-1五个等级,并分析各组的抗生素使用时间、住院时间、痰培养阳性、好转及死亡。结果:病例组血清PCT明显高于对照组,且有统计学意义(P<0.05),而两组WBC计数、CRP均无统计学意义(P>0.05)。随着血清PCT水平的逐渐升高,病例组好转率逐渐下降,抗生素使用时间与需住院时间也延长,痰培养阳性、病死率均呈逐渐上升的趋势(P<0.05)。结论:血清PCT水平分级对慢性阻塞性肺疾病急性加重期的病情诊断、评估预后有指导意义。     

居家护理对慢性阻塞性肺部疾病患者生活质量的影响

目的:探讨居家护理对慢性阻塞性肺部疾病(COPD)患者生活质量的影响。方法:将86例(COPD)患者按出院奇偶数分为观察组和对照组各43例,对照组出院后采用常规护理方法,观察组在此基础上采用居家护理方法,对其生活方式进行干预,采用COPD患者生活质量评定量表,评价两组患者的生活质量,结果:干预6个月后,两组日常生活、社会活动、抑郁、焦虑及生活质量总均分比较,差异有显著性意义(均P<0.05)。结论:居家护理能提高COPD患者的生活质量。     

Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass

BACKGROUND:

High-frequency neuromuscular electrical stimulation increases exercise tolerance in patients with advanced chronic obstructive pulmonary disease (COPD patients). However, it is conceivable that its benefits are more prominent in patients with better-preserved peripheral muscle function and structure.

OBJECTIVE:

To investigate the effects of high-frequency neuromuscular electrical stimulation in COPD patients with better-preserved peripheral muscle function. Design: Prospective and cross-over study.

METHODS:

Thirty COPD patients were randomly assigned to either home-based, high-frequency neuromuscular electrical stimulation or sham stimulation for six weeks. The training intensity was adjusted according to each subject''s tolerance. Fat-free mass, isometric strength, six-minute walking distance and time to exercise intolerance (Tlim) were assessed.

RESULTS:

Thirteen (46.4%) patients responded to high-frequency neuromuscular electrical stimulation; that is, they had a post/pre ΔTlim >10% after stimulation (unimproved after sham stimulation). Responders had a higher baseline fat-free mass and six-minute walking distance than their seventeen (53.6%) non-responding counterparts. Responders trained at higher stimulation intensities; their mean amplitude of stimulation during training was significantly related to their fat-free mass (r  =  0.65; p<0.01). Logistic regression revealed that fat-free mass was the single independent predictor of Tlim improvement (odds ratio [95% CI]  =  1.15 [1.04-1.26]; p<0.05).

CONCLUSIONS:

We conclude that high-frequency neuromuscular electrical stimulation improved the exercise capacity of COPD patients with better-preserved fat-free mass because they tolerated higher training stimulus levels. These data suggest that early training with high-frequency neuromuscular electrical stimulation before tissue wasting begins might enhance exercise tolerance in patients with less advanced COPD.     

慢性阻塞性肺疾病小鼠模型制备方法的比较研究

目的:采用香烟烟雾(cigarette smoke,CS)暴露、肺炎克雷伯杆菌(Klebsiella pneumoniae,KP)感染、聚肌胞苷酸(polyinosinic-polycytidylic acid,Poly I:C)滴鼻、CS暴露联合KP感染和CS暴露联合Poly I:C滴鼻5种方法,建立并比较慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)小鼠模型。方法:将288只雄性BALB/c小鼠随机分为正常组(normal组)、CS组、KP组、CS+KP组、Poly I:C组及CS+Poly I:C组,每组48只。第1～8周造模,分别于第4、8、16和24周末取材。观察小鼠肺组织平均肺泡数(mean alveolar number,MAN)、肺泡平均截距(mean linear intercept,MLI)、肺功能呼气峰流速(peak expiratory flow,PEF)和50%潮气量呼气流量(50%tidal volume expiratory flow,EF50)的变化,检测肺组织中肿瘤坏死因子α(tumor nec...     

Increased CTLA‐4+ T cells may contribute to impaired T helper type 1 immune responses in patients with chronic obstructive pulmonary disease

Impaired T helper type 1 (Th1) function is implicated in the susceptibility of patients with chronic obstructive pulmonary disease (COPD) to respiratory infections, which are common causes of acute exacerbations of COPD (AECOPD). To understand the underlying mechanisms, we assessed regulatory T (Treg) cells and the expression of an inhibitory T‐cell receptor, cytotoxic T‐lymphocyte‐associated antigen 4 (CTLA‐4). Cryopreserved peripheral blood mononuclear cells (PBMC) from patients with AECOPD (n = 17), patients with stable COPD (sCOPD; n = 24) and age‐matched healthy non‐smoking controls (n = 26) were cultured for 24 hr with brefeldin‐A or monensin to detect intracellular or surface CTLA‐4 (respectively) by flow cytometry. T cells in PBMC from AECOPD (n = 9), sCOPD (n = 14) and controls (n = 12) were stimulated with anti‐CD3 with and without anti‐CTLA‐4 blocking antibodies and cytokines were quantified by ELISA. Frequencies of circulating T cells expressing intracellular CTLA‐4 were higher in sCOPD (P = 0·01), whereas patients with AECOPD had more T cells expressing surface CTLA‐4 than healthy controls (P = 0·03). Increased frequencies of surface CTLA‐4⁺ CD4⁺ T cells and CTLA‐4⁺ Treg cells paralleled increases in plasma soluble tumour necrosis factor receptor‐1 levels (r = 0·32, P = 0·01 and r = 0·29, P = 0·02, respectively) in all subjects. Interferon‐γ responses to anti‐CD3 stimulation were inversely proportional to frequencies of CD4⁺ T cells expressing intracellular CTLA‐4 (r = −0·43, P = 0·01). Moreover, CTLA‐4 blockade increased the induction of interferon‐γ, tumour necrosis factor‐α and interleukin‐6 in PBMC stimulated with anti‐CD3. Overall, chronic inflammation may expand sub‐populations of T cells expressing CTLA‐4 in COPD patients and therefore impair T‐cell function. CTLA‐4 blockade may restore Th1 function in patients with COPD and so aid the clearance of bacterial pathogens responsible for AECOPD.     

老年AECOPD患者病毒感染的相关临床特征分析

目的 了解患有慢性阻塞性肺疾病急性发作(Acute exacerbations of chronic obstructive pulmonary disease,AECOPD)老年患者相关病毒感染现状,同时探讨其与临床特征的相关性.方法 选取于2012年7月～2014年10月在我院呼吸科进行治疗并经诊断为AECOPD的老年患者90例作为研究对象,均采集鼻咽拭子,利用多重巢式PCR法对相关呼吸道病毒(9种)进行检测,并根据病毒检测结果将患者分为阳性组及阴性组.搜集两组患者临床特征信息,包括基线资料、临床症状、体征、化验结果及病情变化等,经统计学分析与病毒感染的相关性.结果 纳入的90例患者中,病毒检测阳性有23例,阳性率达25.6％,其中,FluB和hCOV双重感染1例(4.3％)、FluB 4例(17.4％)、RSV2例(8.7％)、hPIV 5例(21.7％)、hCOV 3例(13.0％)、hRV 8例(34.8％),鼻病毒感染患者占据比例最高.对组间临床特征差异进行统计学分析,仅死亡率一项阳性组高于阴性组,且差异具有统计学意义,其他资料差异不存在统计学意义.结论 病毒感染在AECOPD老年患者群体中具有较高检测阳性率,且鼻病毒感染最为多见,病毒感染与患者预后具有一定相关性,但目前临床对病毒感染的特异性检测尚存在一定困难.     

慢性阻塞性肺病患者心理状况及影响因素

调查慢性阻塞性肺疾病（COPD）患者心理状况和影响因素，对60例患者和60例健康者对照，应用焦虑和抑郁情绪表（HAO）对两组进行问卷调查，结果显示，患者评分显著差于健康者，年龄、病程和通气功能与患者抑郁症状和总分呈显著性相关，提示患者伴有心理障碍，重视和兼顾心理症状诊治颇有必要。     

Reproducibility of the parameters of the on-transient cardiopulmonary responses during moderate exercise in patients with chronic obstructive pulmonary disease

To be clinically useful as indices reflective of altered physiological function consequent to interventions in patients with chronic obstructive pulmonary disease (COPD), the time constant (τ) and steady-state amplitude of the kinetic responses for oxygen uptake ( ) carbon dioxide output ( ) ventilation ( ) and heart rate (HR) have to be appropriately differentiable and reproducible. We therefore assessed the reproducibility of τ and steady state amplitude values in 41 patients with severe COPD [mean (SD)] [forced expiratory volume in 1 s=41 (7)% predicted], aged 64 (5) years. Of the total, 6 of the patients (15%) did not produce breath-by-breath data of sufficient quality to warrant kinetic analysis. The remaining 35 patients completed two moderate-intensity 10 min square-wave exercise tests separated by 2 h, both before and after an endurance training programme. Tests were conducted on an electromagnetically-braked cycle ergometer at an exercise intensity corresponding to 80% of the estimated lactate threshold (θ_La) or 50% of peak oxygen uptake if θ_La was insufficiently differentiable. Breath-by-breath measurements of , , and HR were averaged into 10 s bins and the on-transient response kinetics were estimated using a mono-exponential model. Analysing the pre-training and the post-training test 1 and test 2 comparisons together, the test 1 –test 2 differences were not significantly different from 0 for either τ or A. The standard deviation of the test 1 –test 2 differences allowed us to define the magnitude of change that would reach statistical significance. For τ, this averaged some 8, 10, 11 and 8 s, for , , and HR, respectively, for a one-tailed paired-comparisons test (i.e. appropriate for assessing hypothesised improvements resulting from an intervention); for a two-tailed comparison, the differences were approximately 2 s greater. The corresponding one-tailed values for A were 100 ml·min^–1, 95 ml·min^–1, 2.5 1·min^–1 and 4 beats·min^–1, respectively; the two-tailed values were 10%–15% greater. We therefore conclude that both τ and A for moderate-intensity exercise can be reproducibly estimated in patients with COPD when the data set provides a sufficiently large amplitude of response and sufficiently low sample variability to allow appropriate parameter estimation. Electronic Publication     

Training improves muscle oxidative capacity and oxygenation recovery kinetics in patients with chronic obstructive pulmonary disease

We studied 21 patients with chronic obstructive pulmonary disease aged [mean (SD)] 63 (10) years, with a mean forced expiratory volume in 1 s of 40 (6)% and a peak oxygen uptake of 67 (11)% of predicted values. Patients trained for 6 weeks on a cycle ergometer at high work-rates (WR). Near-infrared spectroscopy was used to obtain the time-constant of the deoxygenation recovery signal (τHbO₂) during three constant WR exercise tests, one below and two above the lactic acidosis threshold (θ_L). Glycolytic and oxidative enzymes and lactate concentrations were assessed in muscle biopsies. The τHbO₂ decreased significantly in all three constant WR tests: –18 (24)s, –20 (23) s and –13 (22) s, respectively. Endurance time increased in the higher WR tests, by 5.7 (4.8) min and 3.6 (2.7) min, respectively. The activity of citrate-synthase (CS) and creatine-kinase changed significantly from 20 (10) to 30 (13) μmol·min^–1·g^–1 and from 3.825 (950) to 3.402 (526) μmol·min^–1·g^–1, respectively. Training also improved significantly the mean response time of the on-transient of oxygen uptake (τ'V˙O₂) of the below-θ_L test. We found significant correlations between changes in CS and changes in τHbO₂, τ'V˙O₂ and endurance time. We conclude that leg training accelerates the speed of re-oxygenation of the vastus lateralis muscle after exercise. This improvement is correlated to changes in the oxidative enzymes. Electronic Publication