有氧联合阻抗运动对血液透析患者透析充分性和生活质量的影响

The effects of combined aerobic-resistance training on dialysis adequacy and quality of life in maintenance hemodialysis patients

目的探讨有氧联合阻抗运动对维持性血液透析(maintenance hemodialysis,MHD)患者透析充分性和生活质量的影响。方法选取2021年6月~2022年6月在内蒙古医科大学附属医院血液净化中心的MHD患者40例为研究对象,透析龄≥3个月,采用随机数字表法分为试验组(n=20)和对照组(n=20),透析期间对照组给予常规治疗,包括饮食指导、药物治疗和血液透析治疗。试验组在常规治疗基础上实行运动干预:进行为期24周的有氧联合阻抗运动,3次/w,每次45min。收集干预前后的血尿素氮,计算尿素清除指数(Kt/V)和尿素下降率(urea reduction rate,URR),评估透析充分性。比较干预前后2组健康调查量表(short form 36 questionnaire,SF-36)变化,评价生活质量。结果运动干预24w后试验组Kt/V、URR、一般健康状况(general health status,GH)、躯体功能(physical function,PF)、活力(vitality,VT)、精神健康(mental health,MH)及SF-36总分明显高于对照组(t值分别为2.435、2.218、2.675、2.798、3.188、2.197、4.251,P值分别为0.020、0.033、0.011、0.008、0.003、0.034、<0.001);与基线水平相比,试验组24周时Kt/V、URR、一般健康状况(GH)、躯体功能(PF)、活力(VT)及SF-36总分明显升高(t值分别为-2.880、-7.543、-6.168、-3.587、-7.009、-7.521,P值分别为0.010、<0.001、<0.001、0.002、<0.001、<0.001)。结论有氧联合阻抗运动可以提高MHD患者透析充分性,改善患者生活质量。

Objective To explore the effect of combined aerobic-resistance training on dialysis adequacy and quality of life in maintenance hemodialysis(MHD)patients.Methods A total of 40 MHD patients treat-ed in Blood Purification Center of the Affiliated Hospital of Inner Mongolia Medical University from June 2021 to June 2022 were recruited as the study subjects.Their hemodialysis age was≥3 months.They were di-vided into the test group(n=20)and the control group(n=20)by random number table method.Patients in the control group were given routine treatment,including diet guidance,drug treatment and hemodialysis;those in the test group were asked to perform combined aerobic-resistance training three times a week and 45 min-utes each time for 24 weeks during the dialysis period in addition to the routine treatment.Blood urea nitro-gen,calculated the urea clearance index(Kt/V)and urea reduction rate(URR)before and after the interven-tion were collected to estimate their dialysis adequacy.Changes of the short form 36 questionnaire(SF-36)be-fore and after the intervention were used to compare the quality of life between the two groups.Results Af-ter the execirse intervention for 24 weeks,Kt/V,URR,general health status(GH),physical function(PF),vital-ity(VT),mental health(MH)and total score of SF-36 were significantly higher in the test group than in the control group(t=2.435,2.218,2.675,2.798,3.188,2.197 and 4.251 respectively;P=0.020,0.033,0.011,0.008,0.003,0.034 and<0.001 respectively).In the test group after the exercise training for 24 weeks,Kt/V,URR,GH,PF,VT and total SF-36 score became significantly higher than their baseline levels(t=-2.880,-7.543,-6.168,-3.587,-7.009 and-7.521 respectively;P=0.010,<0.001,<0.001,0.002,<0.001 and<0.001 re-spectively).Conclusion Combined aerobic-resistance training can improve the dialysis adequacy and quality of life in MHD patients.