有氧运动对系统性红斑狼疮患者运动能力生活质量和心境影响的临床研究

Study of supervised aerobic exercise on physical activity, quality of life and psychological status in patients with systemic lupus erythematosus

目的探讨有氧运动对稳定期系统性红斑狼疮（SLE）患者运动能力、生活质量、心理状态和疾病的影响。方法确诊为稳定期的SLE患者分为2组，其中训练组24例和对照组25例，训练组患者每周进行3～4次有氧运动训练，运动强度以最大心率储备值的20％。40％为目标心率，2组患者分别在入组前，入组1、3、6个月后分别进行总体自我感觉（VAS），SLE疾病活动指数（SLEDAI），身体工作能力（PWC170），生活质量（SF-36）和心理量表（POMS）评定。结果2组患者入组前各指标差异无统计学意义（P〉0．05），入组前后资料显示2组患者的VAS，PWC170，POMS和SF-36指标均有不同程度的改善，入组6个月后2组间相比较VAS（P〈0．05），PWC170（P〈0．01）和SF-36中的社会功能训练组明显好于对照组（P〈0．05）。VAS和POM中的5项负面情绪和总分呈负相关（r=-6．26～0．393，P〈0．01），和POM中的2项正面情绪呈正相关（r=0．534～0．611，P〈0．01）。结论稳定期SLE患者可以通过医疗监督下的有氧运动来改善患者的运动能力、生活质量和心理状态，并且对疾病无不良影响。

Objective To evaluate the efficacy of medical supervised aerobic exercise on physical activity, quality of life and psychological status in patients with systemic lupus erythematosus （SLE）. Methods SLE patients who fulfilled ACR criteria were recruited and divided into 2 groups： exercise group （n=24） and control group （n=25）. The patients in the exercise group were supervised to have aerobic exercises. The intensiveness of exercise was determined by 20%-40% of maximum heart rate reservation. Visual analog scale （VAS）, SLE disease activity index （SLEDAI） score, physical working capacity （PWC170）, SF-36 and profile of mood states （POMS） of the two groups were used to evaluate the changes at the baseline, 1 month, 3 months and 6 months after this study. Results The 2 groups were homogeneous and comparable in disease activity at baseline. 1, 3 and 6 months after the study, the VAS, PWC170, POMS and SF -36 of SLE patients were improved in certain degrees in both groups, while the improvement of VAS （P〈0.05）, PWC170 （P〈 0.01） and social function of SF-36 （P〈0.05） of exercise group were significantly more evident than those of the control group in 6 months after study without any impact on disease condition. There was a high negative correlation between VAS and 5 categories of POMS （r=-6.26-0.393, P〈0.01 ） and a more relevant positive association between VAS and 2 categories of POMS （r=0.534-0.611, P〈0.01）. Conclusion The data demonstrate that the supervised aerobic exercise can ameliorate physical capacity, improve quality of life and psychological and emotional status in the state SLE patients without aggravating disease per se.