吸气肌训练联合缬沙坦对血透患者肺功能等的作用

Impacts of inspiratory muscle training combined with valsartan on lung function and other functions of patients with hemodialysis

目的探讨吸气肌训练联合缬沙坦对终末期肾病(ESRD)血液透析患者肺功能、肌肉力量和微炎症状态的影响。方法选取100例行维持性血液透析的ESRD患者,根据随机分为对照组与观察组,各50例。对照组进行吸气肌训练,观察组在对照组的基础上口服缬沙坦胶囊,比较两组治疗前1 w内和治疗12 w后的肺功能、肌肉力量和炎症因子水平。结果治疗前,两组肺活量(FVC)、一秒用力呼气容积(FEV1)和最大呼气流量(PEF)及肌肉力量Lovett分级比较无统计学差异(P> 0.05);治疗后,两组FVC、FEV1和PEF均显著升高,肌肉力量Lovett分级显著改善,且观察组改善幅度均大于对照组(P <0.05)。治疗前两组血清hs-CRP、IL-6和TNF-α比较无统计学差异(P> 0.05);治疗后,两组血清hs-CRP、IL-6和TNF-α显著低于治疗前,且观察组显著低于对照组(P <0.05)。结论吸气肌训练联合缬沙坦治疗,可有效改善ESRD血液透析患者肺功能、肌肉力量和微炎症状态,值得临床推广。

Objective To explore the impacts of inspiratory muscle training combined with valsartan on the lung function,muscle strength and microinflammatory state of patients with end-stage renal disease(ESRD) hemodialysis. Methods A total of 100 patients to receive maintenance hemodialysis were selected and randomly divided into a control group and an observation group(n=50,respectively). The control group received inspiratory muscle training, and on the basis of this, the observation group was further treated with oral administration of valsartan capsule. The lung function, muscle strength and levels of inflammatory factors one week before the treatment and after 12 weeks of the treatment were compared between the two groups. Results Before the treatment, there was no statistical difference in the forced vital capacity(FVC), the force expiratory volume in the first second(FEV1), the peak expiratory flow(PEF) and the Lovett grading of muscle strength between the two groups(P > 0.05); after the treatment, the FVC,FEV1 and PEF in the two groups increased significantly, the Lovett grading of muscle strength significantly improved, and the improvement in the observation group was greater than that in the control group(P < 0.05). Before the treatment, there was no statistical difference in the serum hs-CRP, IL-6 and TNF-α(P > 0.05); after the treatment, the levels of hs-CRP, IL-6 and TNF-α were significantly lower than those before the treatment, and the levels in the observation group were significantly lower than those in the control group(P < 0.05). Conclusion Inspiratory muscle training combined with valsartan can effectively improve the lung function,muscle strength and microinflammatory state of patients with ESRD hemodialysis and is worthy of clinical popularization.