Lundin A P, Stein R A, Brown C D, LaBelle P, Kalman F S, Delano B G, Heneghan W F, Lazarus N A, Krasnow N, Friedman E A
Nephron. 1987;46(1):57-62. doi: 10.1159/000184301.
Aerobic conditioning exercises have been shown to be beneficial for maintenance hemodialysis patients, but biochemical changes during exhaustive exercise in these functionally anephric patients have been less thoroughly studied. We evaluated serum biochemical changes in 7 patients during and after treadmill exercise to patient exhaustion. Duration of exercise was limited by lower leg fatigue without claudication. At exhaustion, only mild changes from baseline rest values were noted in arterial pH (7.39 +/- 0.03-7.33 +/- 0.04) and lactate (0.94 +/- 0.3-5.73 +/- 2.68 mmol/l) despite normal exercise-induced intracellular fluid shifts as evidenced by albumin concentration increases (44.9 +/- 2.8-49.3 +/- 3.1 g/l). Increases in serum K+ concentrations are also modest (change in K from baseline = 0.87 +/- 0.22 mmol/l). An explanation for these minimal biochemical alterations at exhaustion is unclear, but could relate to exercise being limited well below estimated maximum cardiac output and muscle O2 extraction levels by early, unexplained muscle fatigue. Fatigue in hemodialysis patients does not appear to be due to muscle hypoxia.
有氧运动训练已被证明对维持性血液透析患者有益，但对于这些功能性无肾患者在力竭运动期间的生化变化，研究还不够充分。我们评估了7例患者在跑步机运动至力竭期间及之后的血清生化变化。运动持续时间受小腿疲劳限制，无跛行。力竭时，尽管运动引起的细胞内液转移正常，表现为白蛋白浓度升高（44.9±2.8 - 49.3±3.1 g/l），但动脉血pH值（7.39±0.03 - 7.33±0.04）和乳酸（0.94±0.3 - 5.73±2.68 mmol/l）仅较基线静息值有轻微变化。血清钾离子浓度升高也较为适度（钾离子较基线变化 = 0.87±0.22 mmol/l）。力竭时这些生化改变极小的原因尚不清楚，但可能与运动受限于远低于估计的最大心输出量和肌肉氧摄取水平有关，原因是早期出现无法解释的肌肉疲劳。血液透析患者的疲劳似乎并非由肌肉缺氧所致。
