不同运动方式对慢性肾脏病患者肾功能及心血管疾病相关危险因素的影响

The effects of exercises of different types on renal function and the risk factors associated with cardiovascular disease in patients with chronic kidney disease

目的:探究有氧运动和有氧运动联合抗阻训练对慢性肾脏病(CKD)患者肾功能及心血管疾病相关危险因素的影响。方法:87例CKD患者随机分为对照组(n=29)、有氧运动组(n=29)和有氧联合抗阻训练组(n=29)。有氧运动组以50%峰值摄氧量(VO2peak)踏功率自行车,每次30min。有氧联合抗阻训练组先以50%VO2peak踏功率自行车30min,再进行弹力带抗阻训练。两组运动周期均为每周3次,共12周。比较三组间运动前后肾小球滤过率(e GFR)、血肌酐(SCr)、血尿素氮(SBUN)、24h尿蛋白定量(24UP)、收缩压(SBP)、舒张压(DBP)、静息心率(RHR)、甘油三酯(TG)、总胆固醇(TC)和低密度脂蛋白(LDL-C)的差异。结果:运动前三组间各指标均无显著差异(P>0.05);运动后,与对照组相比运动组在e GFR、SCr、SBUN、24UP、SBP、DBP、RHR、TG、TC和LDL-C均有显著改善(P<0.05);且运动后,与有氧运动组相比有氧联合抗阻训练组在TG、TC、和LDL-C改善更明显(P<0.05)。结论:单纯有氧运动和有氧运动联合抗阻训练对CKD患者肾功能及心血管疾病相关危险因素均有改善作用,且与单纯有氧运动相比有氧运动联合抗阻训练对CKD患者的血脂改善效果更好。

Objective： To observe the effects of aerobic training and aerobic combined with resistance training on renal function and the risk factors associated with cardiovascular disease in patients with chronic kidney disease （CKD）. Method： Eighty-seven patients with CKD were divided into control group （n=29）, aerobic training group （n= 29） and aerobic combined with resistance training group （n=29）. Aerobic training group performed cycle ergom- eter at 50%VO：peak for 30 min per time. Aerobic combined with resistance training group firstly performed cy- cle ergometer at 50%VO2peak for 30 min, then performed one section of thera-band resistance training. Train- ing duration of both groups was 12 weeks, 3 times every week. All patients were evaluated the eGFR, SCr, SBUN, 24UP, SBP, DBP, RHR, TG, TC and LDL-C before and after training. Result： There was no significant difference （P〉 0.05） in all variables in three groups before training. After training, the eGFR, SCr, SBUN, 24UP, SBP, DBP, RHR, TG, TC and LDL-C of aerobic training group and aerobic combined with resistance training group were both And there was also significant difference in TG, TC and combined with resistance training group （P 〈 0.05）. significantly different with control group （P〈 0.05）. LDL-C between aerobic training group and aerobic Conclusion： Both aerobic training and aerobic combined with resistance training possesed positive effect on re- nal function and the risk factors associated with cardiovascular disease in patients with CKD. Meanwhile, aero- bic combined with resistance training was more effective to improve blood fat level in patients with CKD.