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血液透析患者透析中周期性运动不会加重微颗粒或循环系统炎症标志物。

Intradialytic cycling does not exacerbate microparticles or circulating markers of systemic inflammation in haemodialysis patients.

机构信息

School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.

NIHR Applied Research Collaboration East Midlands, Leicester Diabetes Centre of Research, University of Leicester, Leicester, UK.

出版信息

Eur J Appl Physiol. 2022 Mar;122(3):599-609. doi: 10.1007/s00421-021-04846-7. Epub 2021 Dec 2.

Abstract

PURPOSE

Patients receiving haemodialysis (HD) display elevated circulating microparticle (MP) concentration, tissue factor (TF) expression and markers of systemic inflammation, though regular intradialytic cycling (IDC) may have a therapeutic effect. This study investigated the impact of regular, moderate-intensity IDC on circulating MPs and inflammatory markers in unit-based HD patients.

METHODS

Patients were cluster-randomised to intervention (n = 20, age: 51.4 ± 18.1 years, body mass: 77.6 ± 18.3 kg, mean ± SD) or no-exercise control (n = 20, 56.8 ± 14.0 years, 80.5 ± 26.5 kg). Intervention participants completed 30 min of moderate intensity (rating of perceived exertion [RPE] of 12-14) IDC, thrice weekly for 6 months. Pre-dialysis venous blood samples were obtained at 0, 3 and 6 months. Circulating MP phenotypes, cytokines, chemokine and MP TF expression were quantified using flow cytometry and cytometric bead array assays.

RESULTS

Despite high exercise compliance (82%), no IDC-dependent effects were observed for any MP, cytokine or chemokine measure (p ≥ 0.051, η ≤ 0.399) other than TNF-α (p = 0.001, η = 0.186), though no significance was revealed upon post hoc analysis.

CONCLUSION

Six months of regular, moderate-intensity IDC had no effect on MPs, cytokines or chemokines. This suggests that the exercise did not exacerbate thrombotic or inflammatory status, though further functional assays are required to confirm this.

TRIAL REGISTRATION

ISRCTN1129707, prospectively registered on 05/03/2015.

摘要

目的

接受血液透析(HD)的患者表现出循环微颗粒(MP)浓度升高、组织因子(TF)表达和全身炎症标志物升高,尽管常规的透析内循环(IDC)可能具有治疗作用。本研究调查了规律、中等强度 IDC 对单位基础血液透析患者循环 MPs 和炎症标志物的影响。

方法

患者被聚类随机分为干预组(n=20,年龄:51.4±18.1 岁,体重:77.6±18.3kg,平均值±标准差)或无运动对照组(n=20,56.8±14.0 岁,80.5±26.5kg)。干预组参与者每周完成 3 次 30 分钟的中等强度(感知用力等级 [RPE] 为 12-14)IDC。在 0、3 和 6 个月时采集透析前静脉血样。使用流式细胞术和细胞计数珠阵列测定法测定循环 MP 表型、细胞因子、趋化因子和 MP TF 表达。

结果

尽管运动依从性很高(82%),但对于任何 MP、细胞因子或趋化因子测量(p≥0.051,η≤0.399),都没有观察到 IDC 依赖性影响,除了 TNF-α(p=0.001,η=0.186),但在事后分析中没有显示出显著性。

结论

6 个月的常规、中等强度 IDC 对 MPs、细胞因子或趋化因子没有影响。这表明运动没有加剧血栓形成或炎症状态,尽管需要进一步的功能测定来确认这一点。

试验注册

ISRCTN843307,于 2015 年 3 月 5 日前瞻性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6efc/8854296/9ce9a0c824c1/421_2021_4846_Fig1_HTML.jpg

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