运动处方应用于非酒精性脂肪性肝病患者治疗作用和安全性评价

doi:10.3969/j.issn.1672-5069.2020.03.015

摘要/Abstract

摘要： 目的探索运动处方在非酒精性脂肪性肝病(NAFLD)患者治疗中的作用和安全性。方法纳入59例NAFLD患者,33例被分配到运动干预组,给予有氧运动和抗阻运动,26例为对照组,未进行特别的运动指导和监督。使用全套“健民4型国民体质测试”设备进行运动前后筛查。使用FibroTouch检测肝内脂肪含量和肝脏硬度。结果在干预组,在干预三个月末,受试者体质量、体质指数、脂肪含量和腰围分别从(81.9±10.4) kg、(28.5±2.4)kg/m²、(25.4±4.9)kg和(92.2±6.5)cm下降至,肝脏脂肪受控衰减参数由(281.5±15.4)dB/m 下降至,而对照组各项指标无显著变化。结论初步研究提示运用运动处方干预NAFLD患者,可收到显著的治疗效果,且安全。

关键词: 非酒精性脂肪性肝病, 运动处方, 有氧运动,抗阻运动, 肝内脂肪含量 , ,

Abstract: Objective The aim of this study was to explore the efficacy and safety of exercise prescription in the treatment of patients with nonalcoholic fatty liver disease (NAFLD). Methods A total of 59 patients with NAFLD were recruited in this study, and were randomly divided into exercise-intervened (n=33) and control group (n=26). The patients with NAFLD in the intervention group were givenexercise prescription with aerobic exercise and resistance movement, and those in the control were not. Results At the end of three-month intervention, the body weights, body mass index, whole body fat contents and waist circumferences in patients with NAFLD in the exercise-intervened group were from (81.9±10.4) kg, (28.5±2.4)kg/m², (25.4±4.9)kg and (92.2±6.5)cm decreased to , and the controlled attenuation parameter decreased from (281.5±15.4)dB/m through , while those parameters didn’t changed significantly in the control. Conclusion Our preliminary studies suggest that exercise prescription is safe, efficacious and tolerable in patients with NAFLD.

Key words: Nonalcoholic fatty liver disease, Exercise prescription, Aerobic exercise, Resistance movement, Controlled attenuation parameter

张亚男,范竹萍. 运动处方应用于非酒精性脂肪性肝病患者治疗作用和安全性评价[J]. 实用肝脏病杂志, 2020, 23(3): 360-363.

Zhang Yanan, Fan Zhuping. Efficacy and safety evaluation of exercise prescription in the treatment ofpatients with nonalcoholic fatty liver disease[J]. Journal of Practical Hepatology, 2020, 23(3): 360-363.

参考文献

[1] Fan JG, Kim SU, Wong VW. New trends on obesity and NAFLD in Asia. J Hepatol, 2017, 67(4):862-873.
[2] 苏淑婷,钟燕,宓余强.非酒精性脂肪性肝病分级分期管理研究进展.实用肝脏病杂志,2019,22(2):293-296.
[3] Romero-Gomez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol ,2017, 67(4):829-846.
[4] Hashida R, Kawaguchi T, Bekki M, et al. Aerobic vs. resistance exercise in non-alcoholic fatty liver disease: A systematic review. J Hepatol,2017, 66(1):142-152.
[5] Chen Y, Xu M, Wang T, et al. Advanced fibrosis associates with atherosclerosis in subjects with nonalcoholic fatty liver disease. Atherosclerosis, 2015, 241(1):145-150.
[6] Chang YK, Chu CH, Chen FT, et al. Combined effects of physical activity and obesity on cognitive function: independent,overlapping, moderator, and mediator Models. Sport Med, 2017, 47(3):449-468.
[7] Fealy CE, Haus JM, Solomon TP, et al. Short-term exercise reduces markers of hepatocyte apoptosis in nonalcoholic fatty liver disease. J Appl Physiol, 2012, 113(1):1-6.
[8] Farrell GC, Chitturi S, Lau GK, et al. Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region: executive summary. J Gastroenterol Hepatol, 2007, 22(6):775-777.
[9] Fan JG, Jia JD, Li YM, et al. Guidelines for the diagnosis and management of nonalcoholic fatty liver disease: update 2010: (published in Chinese on Chinese Journal of Hepatology 2010, 18:163-166). J Dig Dis,2011, 12(1):38-44.
[10] Croci I, Coombes JS, Bucher Sandbakk S ,et al. Non-alcoholic fatty liver disease: Prevalence and all-cause mortality according to sedentary behavior and cardiorespiratory fitness. The HUNT Study. Prog Cardiovasc Dis,2019, 62(2):127-134.
[11] Lavie CJ, Ozemek C, Carbone S, et al. Sedentary behavior, exercise, and cardiovascular health. Circul Res, 2019, 124(5):799-815.
[12] Malaguti C. Critical power for the upper limb in patients with chronic obstructive pulmonary diseases: a pilot study. Respir Physiol Neurobiol, 2019,42:103280.
[13] Fiuza-Luces C, Santos-Lozano A, Joyner M, et al. Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nat Rev Cardiol ,2018, 15(12):731-743.
[14] Colberg SR, Sigal RJ, Yardley JE, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabet Care ,2016, 39(11):2065-2079.
[15] Singleton JR, Marcus RL, Lessard MK, et al. Supervised exercise improves cutaneous reinnervation capacity in metabolic syndrome patients. Ann Neurol, 2015, 77(1):146-153.
[16] Cheng S, Ge J, Zhao C, et al. Effect of aerobic exercise and diet on liver fat in pre-diabetic patients with non-alcoholic-fatty-liver-disease: A randomized controlled trial. Scient Rep, 2017, 7(1):15952.
[17] Katsagoni CN, Georgoulis M, Papatheodoridis GV, et al. Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: A meta-analysis. Metab Clin Experiment, 2017, 68:119-132.