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肝移植受者在接受为期12个月的监督运动计划后的身体状况、血糖、肝功能及生活质量

Physical Condition, Glycemia, Liver Function, and Quality of Life in Liver Transplant Recipients After a 12-Month Supervised Exercise Program.

作者信息

Totti Valentina, Tamè Mariarosa, Burra Patrizia, Mosconi Giovanni, Roi Giulio Sergio, Sella Gianluigi, Ermolao Andrea, Ferrarese Alberto, Sgarzi Sergio, Savino Gustavo, Parodi Giuseppe, Poggioli Giacomo, Ricchiuti Alessandro, Di Michele Rocco, Trerotola Manuela, Nanni Costa Alessandro

机构信息

Department of Biomedical & Neuromotor Sciences, University of Bologna, Bologna, Italy; Associazione Nazionale Emodializzati, Dialisi e Trapianto, Milano, Italy.

Department of Gastrointestinal Diseases, Gastroenterology Division, Sant'Orsola-Malpighi University-Hospital, Bologna, Italy.

出版信息

Transplant Proc. 2019 Nov;51(9):2952-2957. doi: 10.1016/j.transproceed.2019.03.087. Epub 2019 Oct 10.

Abstract

BACKGROUND AND AIMS

Despite the excellent long-term outcomes in liver transplant (LT) recipients, several medical complications related to lifestyle still represent an issue. This study examined the effects of a 12-month supervised aerobic and strength training program on the aerobic capacity, muscle strength, metabolic profile, liver function, and quality of life of a cohort of LT recipients.

METHODS

LT recipients with stable liver function were assigned to interventional exercise (group A) or usual care (group B). Aerobic capacity, muscle strength, metabolic profile, liver and kidney function, and health-related quality of life were assessed at baseline and after 6 and 12 months. Group A attended supervised training sessions 3 times per week for 12 months. Group B received general recommendations about home-based exercise.

RESULTS

Forty patients from 6 Italian LT centers were randomized. Twenty-nine (72.5%, men-to-women ratio 23:6, mean age, 52 ± 8 years) LT recipients completed the study. Baseline characteristics were similar between groups except for body mass index and time from LT. No episode of acute rejection nor increase of transaminases occurred. Maximum workload and body mass index increased in both groups over time, but fasting glucose significantly decreased in group A (94.0 ± 15.0 mg/dL vs 90.0 ± 17.0 mg/dL; P = .037) and increased in controls (95.0 ± 24.0 mg/dL vs 102.0 ± 34.0 mg/dL, P = .04). Upper limb muscle strength increased only in supervised LT recipients. Vitality and general and mental health domains significantly improved after physical exercise.

CONCLUSIONS

Supervised combined training was safe and effective in increasing aerobic capacity, muscle strength, and quality of life and in improving glucose metabolism in stable LT recipients.

摘要

背景与目的

尽管肝移植(LT)受者有出色的长期预后,但一些与生活方式相关的医学并发症仍是问题。本研究探讨了一项为期12个月的有监督的有氧运动和力量训练计划对一组LT受者的有氧运动能力、肌肉力量、代谢状况、肝功能及生活质量的影响。

方法

肝功能稳定的LT受者被分配至干预性运动组(A组)或常规护理组(B组)。在基线、6个月及12个月后评估有氧运动能力、肌肉力量、代谢状况、肝肾功能及健康相关生活质量。A组每周参加3次有监督的训练课程,为期12个月。B组接受关于居家锻炼的一般建议。

结果

来自6个意大利LT中心的40例患者被随机分组。29例(72.5%,男女比例为23:6,平均年龄52±8岁)LT受者完成了研究。除体重指数和LT后的时间外,两组的基线特征相似。未发生急性排斥反应事件,转氨酶也未升高。随着时间推移,两组的最大工作量和体重指数均增加,但A组空腹血糖显著降低(94.0±15.0mg/dL对90.0±17.0mg/dL;P = 0.037),而对照组升高(95.0±24.0mg/dL对102.0±34.0mg/dL,P = 0.04)。仅接受监督的LT受者上肢肌肉力量增加。体育锻炼后活力、总体健康和心理健康领域显著改善。

结论

有监督的联合训练对稳定的LT受者增加有氧运动能力、肌肉力量和生活质量以及改善糖代谢是安全有效的。

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