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Rehabilitation Practice and Science

Translated Title

長期血液透析尿毒症患者之運動心肺功能研究

Abstract

Long term hemodialysis of uremic patients can keep on their living, but they still have many problems like severe anemia, atherosclerosis, and decreasing physical fitness, etc.In this report, a symptomatic maximum bicycle execise test was given to 19 male and 11 female unremic patients who were in stable condition. This test was administered some 18-36 hours after hemodialysis. The patients experienced a progressive increase of resistance on the bicycle until the patient couldn't tolerate it. During exercise, oxygen uptake (VO2), pulmonary ventilation (VE), respiratory exchange ratio (R) and heart rate (HR) were measured breath-by-breath with a MGC-2000 system and lactate level was detemined by the enzymatic method in the venous blood sampled 5 minutes after maximal exercise. The results were compared with the data of 43 male and 19 female healthy adults who had similar physical characteristics. The mean values (±S.D.) of maximum O2 consumption per Kg body weight in male & female uremic patients were 21.4 (±5.5) and 16.0(±2.8) ml/kg/min, which were significantly lower than those respective values in normal males and females (48.3±7.9 & 29.9±4.3ml/kg/min). This was due to the decrease in the maximum heart rate and maximum O2 pulse. The cause of decreased maximal heart rate in uremic patients may be due to the dysfunction of the sympathetic nerous system. Also the abnormal lower O2 pulse may be due to anemia & the decreases in myocardial contractility & oxygen extaction in skeletal muscle. In each case the uremic patients achieved a near normal respiratory exchange ratio which indicated that they had worded up to their maximum physical capacity. But they still had a marked decrease in physical fitness. So, how to improve the physical fitness of uremic patient is worthy of further study.

Language

Traditional Chinese

First Page

59

Last Page

64

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