【摘要】 目的 探讨运动康复对维持性血液透析(maintenance hemodialysis,MHD)患者透析充分性、营养及脂质代谢的影响。方法 选取南通市第二人民医院血液净化中心87位透析不充分的患者，随机分为接受药物和血液透析在内的常规治疗对照组继而在接受常规治疗的同时进行有氧和抗阻运动的运动组。分别在干预前、干预12周和24周时比较2组尿素清除指数(Kt/V)、营养及脂质代谢指标。结果运动组患者干预12周和24周后的Kt/V(t=-4.282、-6.535，均P<0.001)、白蛋白(Alb)(t=-3.603、-5.333,P=0.001、<0.001)均显著高于对照组，运动组胆固醇(TC)(t=4.035、3.918，均P<0.001)、低密度脂蛋白(LDL)(t=2.258、4.483,P=0.027、<0.001)均显著低于对照组。干预24周时运动组C-反应蛋白(CRP)低于对照组(组间Z=-4.349,P<0.001)。与干预前比较，运动组患者干预后12周和24周高密度脂蛋白(HDL)显著提高(t=-2.425、-2.085,P=0.020、0.043)。结论 有氧和抗阻运动对MHD患者的透析充分性、营养状态以及脂质代谢均有显著改善作用。更多还原

【Abstract】 Objective To investigate the effects of exercise rehabilitation on dialysis adequacy, nutrition,and lipid metabolism in maintenance hemodialysis(MHD) patients. Methods A total of 87 patients with inadequate dialysis from the Blood Purification Center of Nantong Second People’s Hospital were selected.They were randomly divided into two groups: a control group receiving conventional treatment(including medication and hemodialysis) and an exercise group receiving conventional treatment plus aerobic and resistance exercises. The urea clearance index(Kt/V), nutritional markers, and lipid metabolism markers were compared between the two groups before the intervention, at 12 weeks(12W), and at 24 weeks(24W). Results After 12 weeks and 24 weeks of intervention, the exercise group showed significantly higher Kt/V(t =-4.282,-6.535; both P <0.001) and serum albumin(Alb) levels(t =-3.603,-5.333; P = 0.001, <0.001) compared to the control group. While the exercise group had significantly lower total cholesterol(TC)(t = 4.035, 3.918;both P< 0.001) and low-density lipoprotein(LDL) levels(t =2.258, 4.483; P =0.027, <0.001) than the control group. At 24 weeks of intervention, C-reactive protein(CRP) in the exercise group was significantly lower than that in the control group(intergroup Z=-4.349, P<0.001). Compared to pre-intervention levels, the exercise group demonstrated significantly increased high-density lipoprotein(HDL) levels at both 12W and24W(t =-2.425,-2.085; P=0.020, 0.043). Conclusion Aerobic and resistance exercise significantly improves dialysis adequacy, nutritional status, and lipid metabolism in MHD patients.更多还原