摘要
目的探讨心肺运动试验(CPET)指导下康复运动对维持性血液透析(MHD)患者免疫功能和疲劳程度的影响。方法将2019年5月—2020年6月扬州市江都人民医院收治的60例MHD患者按照随机数字表法随机分为对照组和运动康复组,每组30例,所有患者治疗前后进行CPET。对照组在常规血液透析管理模式下治疗,运动康复组在对照组常规治疗基础上根据CPET结果制定个体化Δ50%W强度运动方案进行运动康复训练,每周5次,共12周。比较2组入组时及治疗12周后常规生化指标、炎症和免疫指标、疲劳程度CFQ评分、CPET指标、6 min步行试验(6MWT)、心脏超声指标及治疗过程中不良反应发生情况。结果与入组时相比,治疗12周后运动康复组血红蛋白、IgA、IgG、CD3^(+)、CD4^(+)、CD8^(+)、最大摄氧量、无氧阈、6MWT步行试验、左室射血分数均明显升高(P均<0.05),而血磷、C反应蛋白水平及CFQ评分均明显降低(P均<0.05)。治疗12周后与对照组相比,运动康复组IgG、CD3^(+)、CD4^(+)、CD8^(+)及最大摄氧量、无氧阈、6MWT、左室射血分数更高(P均<0.05),C反应蛋白水平及CFQ评分更低(P均<0.05)。结论CPET指导下运动康复可以改善MHD患者炎症状态及免疫功能,减轻疲劳程度,提高运动耐力及心脏功能,且患者耐受性好。
Objective It is to investigate the effect of cardiopulmonary exercise test(CPET)-guided rehabilitation exercise on immune function and fatigue in maintenance hemodialysis(MHD)patients.Methods A total of 60 MHD patients admitted to Yangzhou Jiangdu People’s Hospital from May 2019 to June 2020 were randomly divided into control group and exercise rehabilitation group according to the random number table method,with 30 cases in each group.All patients underwent CPET before and after treatment.The control group was treated under the conventional hemodialysis management mode,and the exercise rehabilitation group was given an individualizedΔ50%W intensity exercise program for exercise rehabilitation training according to the CPET results based on the conventional treatment of the control group,5 times per week,totally treated for 12 weeks.The routine biochemical indexes,inflammatory and immune indexes,CFQ score of fatigue,CPET indexes,6-min walk test(6MWT),cardiac ultrasound indexes at the time of enrollment and after 12 weeks of treatment and the occurrence of adverse reactions during treatment were compared between the two groups.Results Compared with those at the time of enrollment,the hemoglobin,IgA,IgG,CD3^(+),CD4^(+),CD8^(+),maximal oxygen uptake,anaerobic threshold,6MWT walking test and left ventricular ejection fraction were significantly increased after 12 weeks of treatment in the exercise rehabilitation group(all P<0.05),while the levels of serum phosphorus,C-reactive protein and CFQ scores were significantly decreased(all P<0.05).Compared with the control group after 12 weeks of treatment,the levels of IgG,CD3^(+),CD4^(+),CD8^(+),maximum oxygen uptake,anaerobic threshold,6MWT,and left ventricular ejection fraction were higher and the levels of C-reactive protein and CFQ scores were lower in the exercise rehabilitation group(all P<0.05).Conclusion Exercise rehabilitation under the guidance of CPET can improve the inflammatory state and immune function,reduce fatigue,improve exercise tolerance and cardiac function with good tolerance in the treatment of MHD patients.
作者
王维平
姜璐
张强
韩年华
徐瑞
何萍
WANG Weiping;JIANG Lu;ZHANG Qiang;HAN Nianhua;XU Rui;HE Ping(Yangzhou Jiangdu People’s Hospital,Yangzhou 225200,Jiangsu,China)
出处
《现代中西医结合杂志》
CAS
2022年第10期1337-1341,1427,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
扬州市“十三五”科教强卫专项资金项目(ZDRC201836)。
关键词
血液透析
心肺运动试验
疲劳
运动康复
hemodialysis
cardiopulmonary exercise test
fatigue
exercise rehabilitation
