短期有氧运动与 CKD 3 期血管功能：一项随机对照试验。
Short-term aerobic exercise and vascular function in CKD stage 3: a randomized controlled trial.
机构信息
Springfield College, Springfield, MA.
Western New England Renal & Transplant Associates, Springfield, MA.
出版信息
Am J Kidney Dis. 2014 Aug;64(2):222-9. doi: 10.1053/j.ajkd.2014.02.022. Epub 2014 Apr 26.
BACKGROUND
The present study was designed to determine the effect of short-term moderate-intensity exercise training on arterial stiffness in patients with chronic kidney disease (CKD) stage 3.
STUDY DESIGN
Randomized controlled trial with a parallel-group design.
SETTING & PARTICIPANTS: Testing and training sessions were performed at Springfield College. 46 (treatment group, n=25; control group, n=21) patients with CKD with diabetes and/or hypertension completed the study.
INTERVENTION
The aerobic training program consisted of 16 weeks of supervised exercise training at 50%-60% peak oxygen uptake (Vo2peak) 3 times per week, while the control group remained sedentary. Identical testing procedures were performed following the 16-week intervention.
OUTCOMES
The primary outcome was arterial stiffness. Secondary outcomes were aerobic capacity, various blood parameters (endothelin 1, nitrate/nitrite, and high-sensitivity C-reactive protein), and health-related quality of life.
MEASUREMENTS
Arterial stiffness was assessed with aortic pulse wave velocity (PWV), aerobic capacity by Vo2peak, blood parameters by enzyme-linked immunosorbent assays, and health-related quality of life by the 36-Item Short Form Health Survey (SF-36). Participants attended 4 sessions before being randomly assigned to either the treatment or control group. Participants gave consent during the first session, whereas a graded exercise test with measurement of Vo2peak was completed during the second session. During sessions 3 and 4, aortic PWV was measured at rest prior to 40 minutes of either moderate-intensity exercise training or seated rest. A venous blood sample was obtained prior to exercise or rest and participants completed the SF-36 questionnaire.
RESULTS
16 weeks of training led to an 8.2% increase in Vo2peak for the treatment group (P=0.05), but no changes in aortic PWV .
LIMITATIONS
Randomization was not concealed and was violated on one occasion; also, use of an indirect measurement of endothelial function and the short duration of the intervention.
CONCLUSIONS
Short-term moderate-intensity exercise training does not alter arterial stiffness in patients with CKD, but seems to reduce endothelin 1 levels.
背景
本研究旨在确定短期中等强度运动训练对慢性肾脏病（CKD）3 期患者动脉僵硬的影响。
研究设计
随机对照试验，平行组设计。
设置和参与者
测试和训练在斯普林菲尔德学院进行。46 名患有 CKD 合并糖尿病和/或高血压的患者（治疗组 n=25；对照组 n=21）完成了这项研究。
干预
有氧运动方案包括 16 周的监督运动训练，强度为最大摄氧量（Vo2peak）的 50%-60%，每周 3 次，而对照组保持久坐不动。在 16 周的干预后进行了相同的测试程序。
结果
主要结果是动脉僵硬。次要结果是有氧能力、各种血液参数（内皮素 1、硝酸盐/亚硝酸盐和高敏 C 反应蛋白）以及健康相关生活质量。
测量
动脉僵硬用主动脉脉搏波速度（PWV）评估，有氧能力用 Vo2peak 评估，血液参数用酶联免疫吸附测定法评估，健康相关生活质量用 36 项简短健康调查问卷（SF-36）评估。参与者参加了 4 次会议，然后被随机分配到治疗组或对照组。参与者在第一次会议上同意参加，而在第二次会议上完成了一项递增运动试验，测量 Vo2peak。在第 3 次和第 4 次会议期间，在进行 40 分钟的中度强度运动训练或静坐休息之前，在休息时测量主动脉 PWV。在运动或休息前采集静脉血样，并让参与者完成 SF-36 问卷。
结果
治疗组的 Vo2peak 增加了 8.2%（P=0.05），但主动脉 PWV 没有变化。
局限性
随机化未被隐瞒，并且违反了一次；此外，还使用了内皮功能的间接测量和干预时间短。
结论
短期中等强度运动训练不会改变 CKD 患者的动脉僵硬，但似乎可以降低内皮素 1 水平。
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