透析中有氧运动对患者透析充分性、微炎症状态及白蛋白水平影响的Meta分析

Effects of intradialytic aerobic exercise on the dialysis efficacy, inflammation status and albuminin patients onmaintenance hemodialysis:a meta-analysis

目的评价透析中有氧运动对维持性血液透析(MHD)患者透析充分性、微炎症状态及白蛋白水平的影响。方法检索PubMed、Embase、Cochrane图书馆、中国知网、万方、维普等数据库,筛选建库至2018年1月31日的文献,最终纳入19篇文献(均为随机对照试验),采用RevMan 5.1统计软件进行Meta分析。结果 Meta分析结果显示,透析中有氧运动在改善MHD患者透析充分性(MD=0.07,95%CI:0.02～0.12)、微炎症状态(SMD=-1.56,95%CI:-3.03～-0.10)、血清白蛋白(MD=-1.27,95%CI:-2.22～-0.32)、抑郁状态(SMD=-1.27,95%CI:-2.30～-0.24)、疲乏(MD=-2.38,95%CI:-2.72～-2.03)、睡眠情况(SMD=-0.79,95%CI:-1.52～-0.07)等方面有优势,差异均有统计学意义(均P<0.05);但在Hb、TC方面,实验组与对照组比较差异均无统计学意义(均P>0.05)。结论透析中有氧运动能显著改善MHD患者透析充分性、微炎症状态、血清白蛋白水平及抑郁、疲乏、睡眠状况,但在Hb、TC等方面的优势不明显。

Objective To evaluate the effect of intradialytic aerobic exercise on the dialysis efficacy,inflammation status and albumin in patients on maintenance hemodialysis.Methods Randomized controlled trials(RCT)of intradialytic aerobic exercise intervention in patients on maintenance hemodialysis were collected by searching PubMed,Embase and Cochrane library,CNKI,Wanfang,and VIP databases from the inception to January 2018.Nineteen randomized controlled trials were included.Rev-Man 5.1 software was used for meta-analysis.Results Meta-analysis showed that compared with the control group,the intradialytic aerobic exercise significantly improved the dialysis efficacy(MD=0.07,95%CI:0.02~0.12),inflammation status(SMD=-1.56,95%CI:-3.03^-0.10),serum albumin(MD=-1.27,95%CI:-2.22^-0.32),the depression level(SMD=-1.27,95%CI:-2.30^-0.24),the fatigue level(MD=-2.38,95%CI:-2.72^-2.03)and the sleep quality(SMD=-0.79,95%CI:-1.52^-0.07)of the patients on maintenance hemodialysis(all P<0.05).However,in the levels of Hb and TC,there was no significant difference between two groups(both P >0.05).Conclusion Intradialytic aerobic exercise can significantly improve dialysis efficacy,inflammation status,serum albumin,depression,fatigueand sleep quality in patientson maintenance hemodialysis,but not change of the Hb and TC in patients.