【摘要】 目的 探究抗阻与有氧运动康复对糖尿病肾病（DKD）患者肾功能及mTOR通路与自噬水平相关指标的影响。方法 选取2023年1月至2024年1月于新疆医科大学第一附属医院确诊的DKD患者180例，随机分为对照组（90例）和观察组（90例）。对照组采用常规方式护理和基础健康教育，观察组在此基础上给予抗阻和有氧运动康复训练，连续治疗2个月。比较两组患者治疗效果、肾功能[肾小球滤过率（eGFR）、尿白蛋白排泄率（UAER）和胱抑素C（Cys C）]、血糖水平[糖化血红蛋白（HbA1c）、餐后2小时血糖（2hPG）及空腹血糖水平（FBG）]、mTOR通路[PI3K mRNA、AKT mRNA、NF-κB mRNA]及自噬水平[AGR7mRNA、Beclin1 mRNA、LC3 mRNA]相关指标。结果 观察组临床治疗效果优于对照组，差异有统计学意义（P<0.05）；治疗后，观察组CysC和UAER低于对照组，差异有统计学意义（P<0.05）；但两组eGFR指标比较差异无统计学意义（P>0.05）；观察组的HbA₁c、2hPG、FBG指标低于对照组，差异有统计学意义（P<0.05）；观察组的p-PI3K/PI3K、p-AKT/AKT、p-mTOR/mTOR表达低于对照组，差异有统计学意义（P<0.05）；观察组的ATG7 、Beclin1 、LC3表达高于对照组，差异有统计学意义（P<0.05）。结论 抗阻与有氧运动康复训练可有效控制DKD患者的血糖水平，进一步减轻肾脏损伤，降低mTOR信号通路的活性，提升自噬水平，从而增强临床治疗的整体有效率。更多还原

【Abstract】 Objective To explore the effects of resistance and aerobic exercise rehabilitation on renal function and related indicators of the mTOR pathway and autophagy level in patients with diabetic nephropathy(DKD). Methods A total of 180 patients diagnosed with DKD at the First Affiliated Hospital of Xinjiang Medical University from January 2023 to January 2024 were selected and randomly divided into two groups: the control group(90 cases) and the observation group(90 cases). The control group received conventional nursing and basic health education, while the observation group was given resistance and aerobic exercise rehabilitation training on this basis for continuous treatment for 2 months. The therapeutic effects, renal functions(glomerular filtration rate(eGFR), urinary albumin excretion rate(UAER), and cystatin C(Cys C)], blood glucose levels [glycated hemoglobin(HbA1c), 2-hour postprandial blood glucose(2 hPG), and fasting blood glucose level(FBG), and mTOR pathway were compared between the two groups of patients. Indicators related to PI3K mRNA, AKT mRNA, NF-κB mRNA and autophagy levels(AGR7 mRNA, Beclin1 mRNA, LC3 mRNA) were analyzed. Results Compared to the control arm, the intervention arm demonstrated a significantly sbetter therapeutic response(P<0.05). Post-treatment, serum cystatin-C and urinary albumin excretion rates were markedly lower in the intervention arm compared to the control arm(P<0.05). Conversely, estimated glomerular filtration rates did not differ between the arms(P>0.05). Glycemic control indices-HbA1c, 2 hPG and FBG-were all lower in the intervention arm(P<0.05). Furthermore, the phosphorylated-to-total protein ratios of PI3K, AKT, and mTOR were significantly down-regulated, while the autophagy-related proteins ATG7, Beclin-1, and LC3 were up-regulated in the intervention arm(all P<0.05). Conclusion Resistance and aerobic exercise rehabilitation training can effectively control the blood glucose levels of patients with DKD. This helps alleviate renal injury, reduce the activity of the mTOR signaling pathway, and increase the level of autophagy. These effects enhance the overall effectiveness of clinical treatment.更多还原