有氧运动对维持性血液透析患者生理功能、心肺耐力及生活质量的影响

Effects of aerobic exercise training on physical functioning,cardiopulmonary endurance and health related quality of life in maintenance hemodialysis patients

目的探讨12周有氧运动对维持性血液透析(maintenance hemodialysis,MHD)患者生理功能、心肺耐力、健康相关生活质量的影响。方法入选在北京博爱医院就诊的MHD患者14例,所有患者运动前应用Bruce方案平板运动测定最大摄氧量(peak oxygen uptake,VO2peak)、代谢当量(metabolic equivalents,METs)、负荷运动时间等,记录血压和心率。生理功能的评估采用6min步行试验(six-minute walking test,6MWT);心肺耐力的评定采用VO2peak、METs和负荷运动时间;健康相关生活质量的评估采用美国慢性肾脏病临床实践指南(Kidney Disease Outcomes Quality Initiative,K/DOQI)推荐的简易健康相关生活质量评分表(SF-36,the Health-Related Short Form)。有氧运动定义为中等运动强度(50%～80%VO2peak)的平板运动,运动训练在透析间期进行,每周3次,每次30min,共持续12周,运动前15min热身运动,运动结束后5min放松训练,12周运动结束后再次评价上述指标,比较其前后结果有无统计学差异。结果 12周有氧运动后6MWT结果有所改善(Z=-1.132,P=0.241);VO2peak明显提高(Z=-2.226,P=0.028)、负荷运动时间显著延长(Z=-2.701,P=0.007),代谢当量有所提高(Z=-1.632,P=0.103);SF-36评分明显改善(Z=-2.701,P=0.007)。结论 12周有氧运动训练对MHD患者生理功能、心肺耐力、健康相关生活质量有部分改善作用。

Objectives To explore the effect of the 12-week aerobic exercise on physiology function,cardiopulmonary endurance and health related life quality in maintenance hemodialysis(MHD) patients.Methods Fourteen patients from our hospital were enrolled in this study.We measured peak oxygen uptake(VO 2peak),metabolic equivalents(METs) and stress test duration while taking treadmill exercise of Bruce Sport program,meanwhile,blood pressure and heart rate were recorded.Furthermore,the physical function was evaluated by the results of six-minute walking test(6MWT),cardiopulmonary endurance was measured by VO 2peak,METs and stress test duration,and health related quality of life was evaluated by the HealthRelated Short Form questionnaire(SF-36) recommended by Kidney Disease Outcomes Quality Initiative(K/DOQI) clinical practice.Aerobic exercise was defined as treadmill exercise in inter-dialysis of moderate intensity that reaches 50%～80% VO 2peak.The strategy of exercise was 30 minutes each time,three times per week for 12 weeks,which included 15 minutes warming-up before exercises and 5 minutes relaxing after exercises.We then evaluated the parameters after 12 weeks,and explored if there were statistical differences in these parameters before and after aerobic exercise training for 12 weeks.Results 6MWT slightly enhanced(Z =-1.132,P = 0.241),and VO 2peak and stress test duration increased obviously(Z =-2.226,P =0.028 and Z =-2.701,P =0.007,respectively).METs was partially improvement but without statistical significance(Z =-1.632,P =0.103).The results of SF-36 improved significantly(Z =-2.701,P=0.007) after the 12-week exercise.Conclusion The 12-week exercise can partially improve physiological function,cardiopulmonary endurance and health related quality of life in MHD patients.