Weiner P, Zidan F, Zonder H B
Department of Medicine A, Hillel Yaffe Medical Center, Hadera, Israel.
Isr J Med Sci. 1997 Feb;33(2):134-8.
Chronic renal failure can result in a variety of conditions leading to muscle weakness. However, little is known about inspiratory muscle performance and the acute effects of hemodialysis on the muscles. We investigated the inspiratory muscle performance in chronic renal failure patients undergoing maintenance dialysis. Static inspiratory pressures and inspiratory muscle endurance were determined in 21 patients (13 men and 8 women), before and after dialysis. Inspiratory muscle strength before dialysis was significantly reduced in all subjects but one (mean +/- SEM, PImax = 52.9% of predicted). Following dialysis, the static inspiratory pressure was increased in 18 patients, decreased in 1 patient and remained unchanged in 2. Inspiratory muscle endurance was almost normal before dialysis (mean +/- SEM, PmPeak/PImax = 66.1%). Following dialysis, the inspiratory muscle endurance increased in 13 patients, decreased in 5 patients and remained unchanged in 3. There was no significant correlation between inspiratory muscle strength and the time on chronic hemodialysis. We conclude that in patients with chronic renal failure receiving maintenance hemodialysis there is predialysis reduction in inspiratory muscle strength and less significant reduction in the endurance. Both the inspiratory muscle strength and endurance significantly increased following hemodialysis in most but not all of the subjects. The dialysis-induced changes in biochemical parameters may exert opposing effects on inspiratory muscle performance. This might explain the diversity of the results obtained in this study and studies performed by others.
慢性肾衰竭可导致多种状况,进而引发肌肉无力。然而,关于吸气肌功能以及血液透析对肌肉的急性影响,我们所知甚少。我们对接受维持性透析的慢性肾衰竭患者的吸气肌功能进行了研究。在透析前后,对21例患者(13例男性和8例女性)测定了静态吸气压力和吸气肌耐力。除1例患者外,所有受试者透析前的吸气肌力量均显著降低(平均值±标准误,最大吸气压占预计值的52.9%)。透析后,18例患者的静态吸气压力升高,1例降低,2例保持不变。透析前吸气肌耐力基本正常(平均值±标准误,峰值吸气压与最大吸气压之比为66.1%)。透析后,13例患者的吸气肌耐力增加,5例降低,3例保持不变。吸气肌力量与慢性血液透析时间之间无显著相关性。我们得出结论,接受维持性血液透析的慢性肾衰竭患者在透析前吸气肌力量降低,耐力降低程度较轻。在大多数但并非所有受试者中,血液透析后吸气肌力量和耐力均显著增加。透析引起的生化参数变化可能对吸气肌功能产生相反的影响。这或许可以解释本研究以及其他研究所得结果的多样性。