單次中強度的運動對慢性B型及C型肝炎病患肝功能變化耐受性的初步評估

Preliminary Evaluation of Liver Function Tolerance to Moderate Intensity Exercise in Adults with Chronic Hepatitis B and C

台灣是B型肝炎的高盛行率地區，成年人中有15%-20%為慢性B型肝炎帶原者。而台灣一般人口中，約有1-3%為慢性C型肝炎病人，在台灣某些特定鄉鎮社區中，有C型肝炎盛行率高達30%以上的所謂C型肝炎村。對於喜歡規律運動的慢性B型或C型肝炎民眾，尤其是有接受干擾素抗病毒藥物治療的民眾，是否適合中強度的規律運動呢？由於目前台灣這方面的研究資料不多，尤期是缺乏後者的資料，我們將對此點作一研究，以了解其對肝生化學檢查的影響。本研究以60位無心肺疾病且自願參與本研究的民眾為對象，分為慢性B型肝炎組20名、慢性C型肝炎組20名及無肝病民眾（控制組）20名，每位均接受一次30分鐘腳踏車運動訓練，中強度運動訓練目標心跳率的範圍訂於50%-60%最大保留心搏率。對照組為無肝病的健康民眾20名，接受同樣30分鐘中強度運動訓練。血液樣本採集於運動前(T1)，運動後5分鐘(T2)共2次，檢驗肝臟AST與ALT值，觀察其變化。本研究初步結果顯示，中強度運動訓練對慢性B型或C型肝炎病人的肝生化學檢查，在運動前後無顯著的差異。對於接受干擾素合併療法的慢性C型肝炎病人，其運動前後肝生化學檢查指數雖有顯著差異的上升，但無明顯不適症狀。因此，對無心肺疾病之慢性B型或C型肝炎病人而言，單次中強度的運動是可以耐受的。

Taiwan is an area with a high prevalence of hepatitis B virus infection. There are 15-20% chronic hepatitis B surface antigen carriers among the adult population. About 1-3% of the general population of Taiwan has chronic hepatitis C, but the prevalence may exceed 30% (the so-called hepatitis C village) within some communities of Taiwan. Is moderate intensity exercise suitable for chronic hepatitis B or C patients who like regular exercise, especially those patients who are receiving interferon anti-viral therapies? Because there are limited data pertaining to this issue, we investigated the alterations in liver biochemical tests after moderate intensity exercise. Sixty subjects without cardiopulmonary disorders were recruited in this study. Forty subjects (20 with chronic hepatitis B and 20 with chronic hepatitis C.) underwent bicycle training for 30 minutes (training group) and 20 subjects without liver disease also performed the same exercise (control group). The bicycle training was of moderate intensity for 30 minutes. Blood samples were drawn for liver biochemical tests from the subjects prior to beginning the exercise (T1) and 5 minutes (T2) after completing the exercise. There were no significant differences in liver biochemical tests between T1 and T2 in the chronic hepatitis B or C groups. Although an elevation of liver biochemical test after moderate intensify exercise was noted in the chronic hepatitis C patients who were receiving pegylated interferon therapy, they did not have any physical symptoms. We conclude that daily moderate intensity exercise is well-tolerated by patients with chronic hepatitis.