运动疗法提高血液透析充分性的随机对照观察(英文)

Exercise therapy during hemodialysis to improve adequacy of dialysis randomized controlled trial

目的:探讨运动疗法对血液透析(HD)充分性的影响。方法:病情稳定维持性血液透析的尿毒症患者20例,被随机分为运动组和对照组。运动组在HD期间做蹬脚踏器的运动,对照组不运动。观察透析前、后及透析后1小时的尿素氮(BUN)、肌酐(Scr)、尿酸(UA)的下降率及反弹率,并分别测定两组患者的尿素清除指数(Kt/V)、溶质清除指数(SRI)、尿素氮清除量(AUR)、标准化蛋白分解率(nPCR)。结果:在透析时间及费用不增加的情况下,运动组患者BUN,Scr的下降率较对照组明显增加(P<0.05,t=2.129～2.676),BUN,Scr,UA的反弹率较对照组明显降低(P<0.05～0.01,t=2.329～4.154),Kt/V,SRI,AUR明显高于对照组(P<0.05～0.01,t=2.253～3.997),两组nPCR差异无显著性。结论:HD期间的运动可提高HD效果,经济简单,实用可行。

AIM:To investigate the effect of exercise on dialysis adequacy during hemodial ysis(HD). METHODS:20 studies were performed in 20 maintenance hemodialysis patients. Eac h study consisted of a pair of HD treatment;the blood and dialysate flow rates, dialyser and treating time were the same. An adapted exercise cycle was attached to the dialysis bed. The patients of exercise group pedaled the exercise cycle throughout the dialysis, and had a 5-10 minutes rest if they needed. while the patients of a control group had no exercise. BUN,Scr and UA were measured just b efore and after dialysis immediately ,and 60 minutes after dialysis. Furthermore , Kt/V,SRI,AUR and nPCR were detected by on-line dialysis monitor. RESULTS: In the exercise group, after HD, both BUN and Scr decrease rate were significantly higher(P< 0.05,t=2.129-2.676) while the rebound of BUN, Scr and U A were significantly lower than those in the control group (P< 0.05-0.01,t=2.32 9-4.154).Kt/V,AUR and SRI were significant higher in the exercise group than th ose in the control group (P < 0.05-0.01,t=2.253-3.997, respectively), while nP CR showed no significant difference between the two groups.