心肺运动试验指导2型糖尿病患者运动处方临床研究

Clinical study on exercise prescription for type 2 diabetes patients under the guidance of cardiopulmonary exercise test

目的分析在心肺运动试验下指导2型糖尿病(T2DM)患者运动处方的临床意义。方法选择于2020年2月-2021年2月珠海市人民医院就诊的96例T2DM患者,以随机数字表法随机分为对照组和观察组,各48例。对照组采取常规运动处方干预;观察组在心肺运动试验指导下进行运动处方干预。比较2组治疗前后糖代谢(空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素)、心肺功能包括最大摄氧量(VO2 max)、公斤体质量摄氧量(公斤体质量VO2)、跑步时消耗能量值(METs)、最大运动功率(WRmax)、无氧阈值(AT值)、1秒用力呼气容积(FEV1)、用力肺活量(FVC)及脉搏波传导速度(PWV)。结果治疗后,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素、VO2max、公斤体质量VO2、METs、WRmax、AT值、FEV1、FVC、PWV较对照组均更优(P<0.05)。结论对于T2DM患者采取心肺运动试验指导运动处方,可降低患者糖代谢指标,明显改善患者心肺功能,减慢患者PWV。

Objective To analyze the clinical signifi cance of exercise prescription for type 2 diabetes mellitus(T2DM)patients under the guidance of cardiopulmonary exercise test.Methods A total of 96 T2DM patients who came to Zhuhai People's Hospital for treatment from February 2020 to February 2021 were selected as the research objects and were randomly divided into the control group(48 cases)and the observation group(48 cases)according to the random number table method.The control group received routine exercise prescription intervention,and the observation group received exercise prescription intervention under the guidance of the cardiopulmonary exercise test.The glucose metabolism(including fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,fasting insulin)and cardiopulmonary function[including maximum oxygen uptake(VO2 max),therapeutic oxygen uptake per kilogram of body weight(per kilogram of body weight VO2),metabolic equivalent of energy(METs)during running,maximum exercise power(WRmax),anaerobic threshold(AT value),forced expiratory volume in the fi rst second(FEV1),forced vital capacity(FVC),and pulse wave velocity(PWV)]were compared before and after treatment between 2 groups.Results After treatment,fasting blood glucose,2h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,VO2 max,per kilogram of body weight VO2,METs,WRmax,AT value,FEV1,FVC and PWV in the observation group were better than those in the control group(P<0.05).Conclusion For T2DM patients,the use of cardiopulmonary exercise test to guide exercise prescription can reduce the patients'glucose metabolism indexes,signifi cantly improve the patients'cardiopulmonary function,and slow down their PWV.