维持性血液透析患者心肺适能与下肢肌力的相关性及其对峰值摄氧量的影响研究

刘沙沙; 杨文君; 迪丽努尔·麦海提江; 马艺榕

doi:10.3969/j.issn.1671-2390.2026.10.005

您当前的位置：

首页 >

文章列表页 >

维持性血液透析患者心肺适能与下肢肌力的相关性及其对峰值摄氧量的影响研究

临床研究 | 更新时间：2026-10-21

- 维持性血液透析患者心肺适能与下肢肌力的相关性及其对峰值摄氧量的影响研究
- Correlation between cardiorespiratory fitness and lower limb muscle strength in patients undergoing maintenance hemodialysis and its effect on peak oxygen uptake
- 临床肾脏病杂志 2026年26卷第10期页码：933-939
- 作者机构：
  
  新疆医科大学第一附属医院肾病科，乌鲁木齐 830000
- 作者简介：
  
  杨文君，Email：455123651@qq.com
- 基金信息：
  
  “天山英才”医药卫生高层次人才培养计划项目(TSYC202301B051)
- DOI：10.3969/j.issn.1671-2390.2026.10.005
  中图分类号：
- 收稿：2025-11-12，
  
  纸质出版：2026-10-28
- 稿件说明：
移动端阅览
刘沙沙,杨文君,迪丽努尔·麦海提江等.维持性血液透析患者心肺适能与下肢肌力的相关性及其对峰值摄氧量的影响研究[J].临床肾脏病杂志,2026,26(10):933-939.

Liu Sha-sha,Yang Wen-jun,Dilinuer Maihaitijiang,et al.Correlation between cardiorespiratory fitness and lower limb muscle strength in patients undergoing maintenance hemodialysis and its effect on peak oxygen uptake[J].Journal of Clinical Nephrology,2026,26(10):933-939.
刘沙沙,杨文君,迪丽努尔·麦海提江等.维持性血液透析患者心肺适能与下肢肌力的相关性及其对峰值摄氧量的影响研究[J].临床肾脏病杂志,2026,26(10):933-939. DOI： 10.3969/j.issn.1671-2390.2026.10.005.

Liu Sha-sha,Yang Wen-jun,Dilinuer Maihaitijiang,et al.Correlation between cardiorespiratory fitness and lower limb muscle strength in patients undergoing maintenance hemodialysis and its effect on peak oxygen uptake[J].Journal of Clinical Nephrology,2026,26(10):933-939. DOI： 10.3969/j.issn.1671-2390.2026.10.005.

摘要

目的

探究维持性血液透析患者心肺适能（cardiorespiratory fitness，CRF）与下肢肌力的相关性，以及影响峰值摄氧量的独立因素。

方法

采用单中心回顾性分析，选取新疆医科大学第一附属医院肾病科2024年1月至2025年1月期间收治的330例维持性血液透析患者为研究对象，作为患病组，并匹配326名同期健康人群作为健康组。通过心肺运动测试评估CRF，伸膝力量测量量化下肢肌力，结合6 min步行距离测试反映运动耐力。比较两组受试者各指标差异，并运用多元线性回归分析，深入探究影响维持性血液透析患者峰值摄氧量的关键因素。

结果

患病组患者在关键体能指标上均显著劣于健康组：峰值摄氧量［（14.33±2.68）mL·kg

-1

·min

-1

比（21.36±2.76）mL·kg

-1

·min

-1

］、伸膝力量［（26.65±3.69）kg 比（43.49±5.65）kg］及6 min步行距离［（419.65±37.98）m比（533.32±24.56）m］均较低，而计时起立行走试验（timed up and go test，TUGT）时间［（12.39±2.98）s比（8.95±2.45）s］更长（

均

0.05）。相关性分析显示，峰值摄氧量与伸膝力量、6 min步行距离呈正相关（

=0.631、0.589，

0.05），与TUGT呈负相关（

=-0.613，

0.05）。多元线性回归进一步证实，年龄、肌肉量减少及肌力减退是影响峰值摄氧量的独立危险因素（

0.05），且变量间无显著共线性（

VIF

均

5）。

结论

维持性血液透析患者CRF与下肢肌力密切相关，年龄增长、肌肉量减少及肌力减退是影响峰值摄氧量的关键因素。通过针对性干预下肢肌力，可有效提升峰值摄氧量，进而改善患者运动耐力与生活质量，对优化临床康复策略具有重要指导价值。

Abstract

Objective

To investigate the correlation between cardiorespiratory fitness （CRF） and lower limb muscle strength in patients undergoing maintenance hemodialysis， and to identify the independent factors affecting peak oxygen uptake.

Methods

A single-center retrospective analysis was conducted. A total of 330 patients undergoing maintenance hemodialysis who were admitted to the Department of Nephrology of the First Affiliated Hospital of Xinjiang Medical University from January 2024 to January 2025 were selected as the disease group， and 326 matched healthy individuals from the same period were included as the healthy group. CRF was assessed by cardiopulmonary exercise testing， lower limb muscle strength was quantified by knee extension strength measurement， and exercise endurance was reflected by the 6-minute walk distance test. Differences in each indicator were compared between the two groups， and multivariate linear regression analysis was used to further explore the key factors affecting peak oxygen uptake in patients undergoing maintenance hemodialysis.

Results

Compared with the healthy group， patients in the disease group showed significantly poorer performance in key physical fitness indicators： peak oxygen uptake （［14.33±2.68］ mL·kg

-1

·min

-1

［21.36±2.76］ mL·kg

-1

·min

-1

）， knee extension strength （［26.65±3.69］ kg

［43.49±5.65］ kg）， and 6-minute walk distance （［419.65±37.98］ m

［533.32±24.56］ m） were all lower， whereas the timed up and go test （TUGT） time （［12.39±2.98］ s

［8.95±2.45］ s） was longer （all

0.05）. Correlation analysis showed that peak oxygen uptake was positively correlated with knee extension strength and 6-minute walk distance （

=0.631， 0.589；

0.05）， and negatively correlated with TUGT （

=-0.613，

0.05）. Multivariate linear regression further confirmed that age， reduced muscle mass， and decreased muscle strength were independent risk factors affecting peak oxygen uptake （

0.05）， and there was no significan

t collinearity among variables （all

VIF

5）.

Conclusion

CRF is closely associated with lower limb muscle strength in patients undergoing maintenance hemodialysis. Advancing age， reduced muscle mass， and decreased muscle strength are key factors affecting peak oxygen uptake. Targeted intervention to improve lower limb muscle strength can effectively increase peak oxygen uptake， thereby improving exercise endurance and quality of life， and may provide important guidance for optimizing clinical rehabilitation strategies.

关键词

Keywords

references

邓天娇 , 蒋亚芬 , 张青云 , 等 . 基于列线图的维持性血液透析患者生存预后预测 [J ] . 湖南师范大学学报(医学版) , 2024 , 21 ( 2 ): 107 - 113 . DOI: 10.3969/j.issn.1673-016X.2024.02.020 http://dx.doi.org/10.3969/j.issn.1673-016X.2024.02.020 .

Deng TJ , Jiang YF , Zhang QY , et al . Prediction of survival and prognosis of maintenance hemodialysis patients based on nomogram [J ] . J Hunan Norm Univ Med Sci , 2024 , 21 ( 2 ): 107 - 113 . DOI: 10.3969/j.issn.1673-016X.2024.02.020 http://dx.doi.org/10.3969/j.issn.1673-016X.2024.02.020 .

马娟 , 侯彦杰 , 陈路锋 , 等 . 肌肉质量减少对不同部位肿瘤病人的预后分析 [J ] . 肠外与肠内营养 , 2024 , 31 ( 5 ): 293 - 299 . DOI: 10.16151/j.1007-810x.2024.05.007 http://dx.doi.org/10.16151/j.1007-810x.2024.05.007 .

Ma J , Hou YJ , Chen LF , et al . Analysis of muscle mass reduction on the prognosis of patients with tumors in different locations [J ] . Parenter Enter Nutr , 2024 , 31 ( 5 ): 293 - 299 . DOI: 10.16151/j.1007-810x.2024.05.007 http://dx.doi.org/10.16151/j.1007-810x.2024.05.007 .

贲峰 , 顾顺忠 , 陆洋 . 心肺运动试验指导下高强度间歇训练对慢性心力衰竭患者心肺功能及体适能的影响 [J ] . 临床内科杂志 , 2025 , 42 ( 7 ): 603 - 605 . DOI: 10.3969/j.issn.1001-9057.2025.07.022 http://dx.doi.org/10.3969/j.issn.1001-9057.2025.07.022 .

Ben F , Gu SZ , Lu Y . Effect of high-intensity interval training under the guidance of cardiopulmonary exercise test on cardiopulmonary function and physical fitness of patients with chronic heart failure [J ] . J Clin Intern Med , 2025 , 42 ( 7 ): 603 - 605 . DOI: 10.3969/j.issn.1001-9057.2025.07.022 http://dx.doi.org/10.3969/j.issn.1001-9057.2025.07.022 .

丁浩 , 危志强 , 印荻 , 等 . 慢性肾脏病患者肌肉质量下降的影响因素分析 [J ] . 重庆医学 , 2020 , 49 ( 16 ): 2711 - 2714, 2718 .

Ding H , Wei ZQ , Yin D , et al . Analysis of factors associated with decreased muscle mass in chronic kidney disease patients [J ] . Chongqing Med , 2020 , 49 ( 16 ): 2711 - 2714, 2718 .

Nascimento Alves M , Souza Soares A , Melo Marinho P . Efficacy of resistance exercise during hemodialysis on improving lower limb muscle strength in patients with chronic kidney disease: a meta-analysis of randomized clinical trials [J ] . Physiother Theory Pract , 2024 , 40 ( 6 ): 1351 - 1361 . DOI: 10.1080/09593985.2022.2141084 http://dx.doi.org/10.1080/09593985.2022.2141084 .

许明煜 , 李威亚 , 周浩锋 , 等 . 峰值摄氧量对中国冠状动脉粥样硬化性心脏病患者不良预后的预测价值 [J ] . 岭南心血管病杂志 , 2024 , 30 ( 2 ): 135 - 140 . DOI: 10.3969/j.issn.1007-9688.2024.02.03 http://dx.doi.org/10.3969/j.issn.1007-9688.2024.02.03 .

Xu MY , Li WY , Zhou HF , et al . Prognostic value of peak oxygen consumption for adverse outcomes in Chinese people with coronary artery disease [J ] . South China J Cardiovasc Dis , 2024 , 30 ( 2 ): 135 - 140 . DOI: 10.3969/j.issn.1007-9688.2024.02.03 http://dx.doi.org/10.3969/j.issn.1007-9688.2024.02.03 .

朱张逸 , 张昆 , 李馨 , 等 . 维持性血液透析患者运动耐量的影响因素分析 [J ] . 临床肾脏病杂志 , 2023 , 23 ( 10 ): 793 - 797 . DOI: 10.3969/j.issn.1671-2390.2023.10.001 http://dx.doi.org/10.3969/j.issn.1671-2390.2023.10.001 .

Zhu ZY , Zhang K , Li X , et al . Factors influencing exercise tolerance in maintenance hemodialysis patients [J ] . J Clin Nephrol , 2023 , 23 ( 10 ): 793 - 797 . DOI: 10.3969/j.issn.1671-2390.2023.10.001 http://dx.doi.org/10.3969/j.issn.1671-2390.2023.10.001 .

马月 , 陈玉华 , 顾浩然 . 亚洲肌少症工作组专家共识解读及对我国社区老年人肌少症防治的启示 [J ] . 中国医药导报 , 2023 , 20 ( 36 ): 189 - 193 . DOI: 10.20047/j.issn1673-7210.2023.36.41 http://dx.doi.org/10.20047/j.issn1673-7210.2023.36.41 .

Ma Y , Chen YH , Gu HR . Interpretation of expert consensus of Asian Working Group for Sarcopenia and implications for prevention and treatment of sarcopenia in Chinese community elderly [J ] . China Med Her , 2023 , 20 ( 36 ): 189 - 193 . DOI: 10.20047/j.issn1673-7210.2023.36.41 http://dx.doi.org/10.20047/j.issn1673-7210.2023.36.41 .

李泽甜 , 且亚玲 , 张雪 , 等 . 老年肌力减少症与肌肉衰减症患者身体成分的比较 [J ] . 西南医科大学学报 , 2024 , 47 ( 5 ): 420 - 427 . DOI: 10.3969/j.issn.2096-3351.2024.05.010 http://dx.doi.org/10.3969/j.issn.2096-3351.2024.05.010 .

Li ZT , Qie YL , Zhang X , et al . A comparative study of body composition in elderly patients with dynapenia and sarcopenia [J ] . J Southwest Med Univ , 2024 , 47 ( 5 ): 420 - 427 . DOI: 10.3969/j.issn.2096-3351.2024.05.010 http://dx.doi.org/10.3969/j.issn.2096-3351.2024.05.010 .

Lin YL , Liu CH , Lai YH , et al . Association of serum indoxyl sulfate levels with skeletal muscle mass and strength in chronic hemodialysis patients: a 2-year longitudinal analysis [J ] . Calcif Tissue Int , 2020 , 107 ( 3 ): 257 - 265 . DOI: 10.1007/s00223-020-00719-x http://dx.doi.org/10.1007/s00223-020-00719-x .

李洪 , 陈汝满 , 曾欣 , 等 . 维持性血液透析患者肌少症患病的风险因素分析 [J ] . 中华肾脏病杂志 , 2023 , 39 ( 11 ): 815 - 821 .

Li H , Chen RM , Zeng X , et al . Analysis of risk factors of sarcopenia in maintenance hemodialysis patients [J ] . Chin J Nephrol , 2023 , 39 ( 11 ): 815 - 821 .

聂宇昕 , 张沥文 , 杨强 , 等 . 维持性血液透析患者超声心动图异常情况及危险因素分析 [J ] . 中国临床医学 , 2023 , 30 ( 3 ): 404 - 413 . DOI: 10.12025/j.issn.1008-6358.2023.20230240 http://dx.doi.org/10.12025/j.issn.1008-6358.2023.20230240 .

Nie YX , Zhang LW , Yang Q , et al . Echocardiography abnormalities and related risk factors in patients with maintenance hemodialysis [J ] . Chin J Clin Med , 2023 , 30 ( 3 ): 404 - 413 . DOI: 10.12025/j.issn.1008-6358.2023.20230240 http://dx.doi.org/10.12025/j.issn.1008-6358.2023.20230240 .

陈杨 , 杨玉洁 , 邱瑛 , 等 . 维持性血液透析患者的相位角在肌肉力量与肌肉功能间的中介效应分析 [J ] . 华西医学 , 2025 , 40 ( 7 ): 1061 - 1066 . DOI: 10.7507/1002-0179.202405217 http://dx.doi.org/10.7507/1002-0179.202405217 .

Chen Y , Yang YJ , Qiu Y , et al . Mediating effect of phase angle between muscle strength and muscle function in patients with maintenance hemodialysis [J ] . West China Med J , 2025 , 40 ( 7 ): 1061 - 1066 . DOI: 10.7507/1002-0179.202405217 http://dx.doi.org/10.7507/1002-0179.202405217 .

蔡根莲 , 应金萍 , 王春燕 , 等 . 维持性血液透析患者肌肉衰减综合征现状及影响因素分析 [J ] . 中国实用护理杂志 , 2021 , 37 ( 6 ): 437 - 442 . DOI: 10.3760/cma.j.cn211501-20200504-02159 http://dx.doi.org/10.3760/cma.j.cn211501-20200504-02159 .

Cai GL , Ying JP , Wang CY , et al . Analysis of the current situation and influencing factors of sarcopenia in maintenance hemodialysis patients [J ] . Chin J Pract Nurs , 2021 , 37 ( 6 ): 437 - 442 . DOI: 10.3760/cma.j.cn211501-20200504-02159 http://dx.doi.org/10.3760/cma.j.cn211501-20200504-02159 .

Faye M , Lemrabott AT , Keita N , et al . Pulmonary hypertension in chronic hemodialysis patients at Aristide le dantec university hospital [J ] . OJNeph , 2022 , 12 ( 1 ): 93 - 100 . DOI: 10.4236/ojneph.2022.121009 http://dx.doi.org/10.4236/ojneph.2022.121009 .

张晓 , 张伟 , 王尊理 , 等 . 维持性血液透析患者计时站立行走测试时间延长的影响因素分析 [J ] . 首都医科大学学报 , 2025 , 46 ( 1 ): 130 - 135 . DOI: 10.3969/j.issn.1006-7795.2025.01.020 http://dx.doi.org/10.3969/j.issn.1006-7795.2025.01.020 .

Zhang X , Zhang W , Wang ZL , et al . Analysis of influencing factors of time prolongation of time up and go test in maintenance hemodialysis patients [J ] . J Cap Med Univ , 2025 , 46 ( 1 ): 130 - 135 . DOI: 10.3969/j.issn.1006-7795.2025.01.020 http://dx.doi.org/10.3969/j.issn.1006-7795.2025.01.020 .

郑树斌 , 平伟 , 王麒 , 等 . 心肺运动试验联合心肌灌注显像预测围术期心血管不良事件发生风险 [J ] . 武汉大学学报(医学版) , 2025 , 46 ( 3 ): 370 - 374 .

Zheng SB , Ping W , Wang Q , et al . Cardiopulmonary exercise testing combined with myocardial perfusion imaging predicts the risk of perioperative cardiovascular adverse events [J ] . Med J Wuhan Univ , 2025 , 46 ( 3 ): 370 - 374 .

Chou HH , Lin JY , Shen GT , et al . Validation of an automated cardiothoracic ratio calculation for hemodialysis patients [J ] . Diagnostics , 2023 , 13 ( 8 ): 1376 . DOI: 10.3390/diagnostics13081376 http://dx.doi.org/10.3390/diagnostics13081376 .

白金晨 , 李英 . 代谢相关脂肪性肝病患者峰值摄氧量降低的影响因素 [J ] . 山东医药 , 2022 , 62 ( 19 ): 52 - 54 . DOI: 10.3969/j.issn.1002-266X.2022.19.012 http://dx.doi.org/10.3969/j.issn.1002-266X.2022.19.012 .

Bai JC , Li Y . Influencing factors of decreased peak oxygen uptake in patients with metabolic-related fatty liver disease [J ] . Shandong Med J , 2022 , 62 ( 19 ): 52 - 54 . DOI: 10.3969/j.issn.1002-266X.2022.19.012 http://dx.doi.org/10.3969/j.issn.1002-266X.2022.19.012 .

邵明璐 , 任敏 , 庄燕 , 等 . 基于心肺功能监测的个体化运动配合针刺夹脊穴对PCI术后患者氧化应激相关指标的影响 [J ] . 保健医学研究与实践 , 2024 , 21 ( 7 ): 83 - 89 . DOI: 10.11986/j.issn.1673-873X.2024.07.14 http://dx.doi.org/10.11986/j.issn.1673-873X.2024.07.14 .

Shao ML , Ren M , Zhuang Y , et al . Impact of individualized exercise based on cardiopulmonary monitoring combined with acupuncture at Jiaji points on oxidative stress-related indicators in patients after PCI [J ] . Health Med Res Pract , 2024 , 21 ( 7 ): 83 - 89 . DOI: 10.11986/j.issn.1673-873X.2024.07.14 http://dx.doi.org/10.11986/j.issn.1673-873X.2024.07.14 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

血液透析患者高钾血症流行病学研究及影响因素分析

生物电阻抗矢量分析在血液透析患者中的应用价值

维持性血液透析合并Wernicke脑病2例

老年慢性肾衰竭患者行连续性肾脏替代疗法治疗期间体外循环管路凝血风险预测列线图的构建与验证

透析治疗后尿毒症患者并发高磷血症危险因素分析及预测模型构建的研究