中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (06): 390-393.doi: 10.3969/j.issn.1671-4091.2019.06.004

• 临床研究 • 上一篇    下一篇

血液透析中运动对维持性血液透析患者炎症、氧化应激及内皮功能的影响

王晓菁1,张昆1,葛颜1,王爱丽1,余晨1   

  1. 1. 同济大学附属同济医院肾内科
  • 收稿日期:2018-08-13 修回日期:2019-04-23 出版日期:2019-06-12 发布日期:2019-06-12
  • 通讯作者: 张昆 jsw_stone@sina.com E-mail:jsw_stone@sina.com
  • 基金资助:

     上海申康医院发展中心慢性病综合防治项目(SHDC12015307)

Effects of intradialytic exercise on inflammation, oxidative stress and endothelial function in patients with maintenance hemodialysis

  • Received:2018-08-13 Revised:2019-04-23 Online:2019-06-12 Published:2019-06-12

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摘要： 【摘要】目的探讨血液透析中运动对血液透析患者炎症、氧化应激及内皮功能的影响。方法筛选2015 年3 月～2016 年3 月在同济大学附属同济医院维持性血液透析超过6 个月的40 例患者，随机分为实验组和对照组，每组20例，实验组接受透析中运动。实验前后收集一般资料及生化检查如血红蛋白、超敏C-反应蛋白、血清白蛋白、尿素清除指数Kt/V、血钙磷及甲状旁腺激素等，ELISA 方法检测白细胞介素-6(interleukin-6，IL-6)、氧化低密度脂蛋白(oxidized low density lipoprotein, oxLDL)、血清可溶性细胞间粘附分子(serum soluble intercellular adhesion molecule,sICAM)及血清可溶性血管细胞粘附分子(serum soluble vascular cell adhesion molecule,sVCAM)。结果经24 周干预后，实验组血红蛋白、血清白蛋白、尿素清除指数Kt/V、IL-6 及oxLDL 较干预前均无显著差异(t 值分别为-0.110, -1.396, -0.889, -0.229, 0.385, P 值分别为0.913, 0.171, 0.380, 0.820, 0.702)，实验组血磷、hsCRP、sICAM及sVCAM 较干预前差异具有统计学意义(t 值分别为2.039, 2.219, 2.309, 2.211, P 值分别为0.048, 0.033, 0.026, 0.033)，干预后实验组Kt/V、hsCRP、sICAM 及sVCAM 较对照组差异具有统计学意义(t 值分
别为3.706,-3.144,-2.570,-3.272,P 值分别为0.001,0.003,0.014,0.002)。结论血液透析中运动可改善维持性血液透析患者炎症及内皮功能，但对氧化应激没有明确作用。

关键词: 血液透析, 运动, 炎症, 氧化应激, 内皮功能

Abstract: 【Abstract】Objective To investigate the effects of intradialytic exercise on inflammation, oxidative stress and endothelial function in maintenance hemodialysis (MHD) patients. Methods Forty patients undergoing MHD for more than 6 months in Tongji Hospital Affiliated to Tongji University from March 2015 to March 2016 were enrolled in this study. They were randomly divided into experimental group in which patients did intradialytic exercise (n=20) and control group (n=20). Clinical data and biochemical results including hemoglobin, high sensitive c- reactive protein (hsCRP), serum albumin, urea clearance index (Kt/V), serum calcium and phosphorus and parathyroid hormone (PTH) were recruited. Blood samples were collected before and after the intervention for the assay of interleukin-6 (IL-6), oxidized low density lipoprotein (ox-LDL), serum soluble intercellular adhesion molecule (sICAM) and serum soluble vascular cell adhesion molecule (sVCAM) by ELISA. Results After the intervention for 24 weeks, there were no significant differences in hemoglobin, serum albumin, urea clearance index Kt/V, IL-6 and oxLDL before and after the intervention in the experimental group (t=- 0.110, - 1.396, - 0.889, - 0.229 and 0.385 respectively; P=0.913, 0.171, 0.380, 0.820 and 0.702 respectively); but there were statistical differences in serum phosphorus, hsCRP, sICAM and sVCAM before and after the intervention in the experimental group (t=2.039, 2.219, 2.309 and 2.211 respectively; P=0.048, 0.033, 0.026 and 0.033 respectively). There were also statistical differences in serum Kt/V, hsCRP, sICAM and sVCAM after the intervention between the experimental group and control group (t =3.706,  -3.144, -2.570 and -3.272 respectively; P=0.001, 0.003, 0.014 and 0.002 respectively). Conclusion Intradialytic exercise can improve inflammation and endothelial function but has no definite effect on oxidative stress in MHD patients.

Key words: Hemodialysis, Exercise, Inflammation, Oxidative stress, Endothelial function