透析中运动对维持性血液透析患者运动能力和透析效率影响的Meta分析

The effects of intradialytic exercise on athletic ability and dialysis adequacy in maintenance hemodialysis patients:a meta-analysis

目的系统评价透析中运动对维持性血液透析患者运动能力和透析效率的影响。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、CNKI、VIP、WanFang Data等数据库中对维持性血液透析患者进行透析中运动干预的随机对照试验,检索时限截至2020年7月。由2位研究者根据纳入与排除标准进行文献筛选、资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果最终纳入文献22篇,共计1057例患者。Meta分析结果显示:透析中运动组在延长6min步行距离[MD=69.070,95%CI(54.710-83.440),P<0.001]、缩短10次坐立时间[SMD=-0.770,95%CI(-1.170--0.380),P<0.001]、提高峰值摄氧量[SMD=0.460,95%CI(0.070-0.850),P=0.020]、提高Kt/V[MD=0.090,95%CI(0.020-0.170),P=0.010]方面均明显优于对照组。结论透析中运动可增强患者运动能力,提高透析效率。

Objective To systematically evaluate the effects of intradialytic exercise on athletic ability and dialysis adequacy in maintenance hemodialysis(MHD)patients.Methods The databases of PubMed,Embase,Web of science,Cochrane Library,CNKI,VIP and WanFang were retrieved from the establishment of the database to July 2020 for the randomized controlled trials of intradialytic exercise.Two investigators screened the literature according to the inclusion and exclusion criteria.After data extraction and quality assessment,the software of RevMan 5.3 was used for meta-analysis.Results A total of 22 studies which included 1,057 participants were analyzed.Meta-analysis showed that the intradialytic exercise group had better outcomes than the control group in 6-minute walk distance(MD=69.070,95%CI 54.710-83.440,P<0.001),10 sit-to-stand-to-sit cycles(SMD=-0.770,95%CI-1.170--0.380,P<0.001),peak oxygen uptake(VO_(2)peak)(SMD=0.460,95%CI 0.070-0.850,P=0.020),and Kt/V(MD=0.090,95%CI 0.020-0.170,P=0.010).Conclusion Intradialytic exercise can enhance athletic ability and improve dialysis adequacy in MHD patients.