综合康复训练对老年慢性肾脏病并发肌少症的效果

Effect of Structured Exercise Training on Old Patients with Chronic Kidney Disease Complicated with Sarcopenia

目的观察低中强度有氧运动联合抗阻运动对老年慢性肾脏病并发肌少症患者的临床疗效。方法选取2018年至2019年在本院老年科就诊的慢性肾脏病并发肌少症的老年患者11例,在常规内科治疗的基础上给予低中强度有氧运动联合抗阻运动干预。每运动单元包括有氧运动30~50 min联合抗阻运动20~30min,每周3次,连续12周。运动前,运动24 h、6周和12周后,测量相关指标。结果与运动前比较,首次运动24 h后及6周和12周后,各项血脂和肾功能指标无明显变化(P> 0.05)。与运动前比较,运动6周后座椅前伸试验距离改善(P <0.05);运动12周后,四肢骨骼肌质量指数、握力指数、6米步速、峰值摄氧量(VO2peak)、睁眼单腿站立时间、座椅前伸试验距离均改善(P <0.05)。与运动6周后比较,运动12周后,握力指数、6米步速、VO2peak、睁眼单腿站立时间改善(P <0.05)。结论低中强度有氧运动联合抗阻运动综合康复训练对老年慢性肾脏病并发肌少症患者的肾功能无明显影响,但可以提高其肌肉质量、肌肉力量和运动功能。

Objective To observe the clinical effect of low and medium intensity aerobic exercise combined with resistance exercise on patients with chronic kidney disease(CKD) complicated with sarcopenia.Methods From 2018 to 2019, 11 elderly patients with CKD complicated with sarcopenia were enrolled in this study. All the patients received low and medium intensity aerobic exercise combined with resistance exercise intervention on the basis of regular internal medical treatment. Each exercise section included 30 to 50 minutes of aerobic exercise and 20 to 30 minutes of resistance exercise, and was conducted three times a week for twelve weeks. Before exercise, and 24 hours, six weeks and twelve weeks after exercise, the related indicators were measured.Results No statistical difference in serum lipids and renal function indicators was found 24 hours after exercise, and six and twelve weeks post exercise(P > 0.05). Compared with pre-exercise condition, the reach in seat increased six weeks after exercise(P < 0.05);the appendicular skeletal muscle mass index, the grip strength index, the 6-meter walking speed, the peak oxygen uptake(VO2peak), the one-leg standing time and the reach in seat improved twelve weeks after exercise(P < 0.05). Compared with the results six weeks after exercise, the grip strength index, the 6-meter walking speed, VO2peak and the one-leg standing time improved twelve weeks after exercise(P < 0.05).Conclusion Structured exercise training of low and medium intensity aerobic exercise combined with resistance exercise training would not worsen the renal function of patients with CKD complicated with sarcopenia;however, it could improve the muscle mass, strength and motor function of them.