摘要目的 探讨不同运动强度对2型糖尿病(T2DM)患者生活质量(QOL)的影响. 方法 选取2013年7月至2014年11月就诊的84例T2DM患者,SF-36健康调查问卷评价生活质量.所有患者通过运动平板试验计算最大耗氧量,以最大耗氧量的40%~60%对应心率作为患者运动时的靶心率,按入组前后顺序分为A组(每日运动0.5 h)和B组(每日运动1 h).12周后观察患者代谢指标、体成分及生活质量的改变.组间计数资料比较用χ2检验. 结果 入组患者A组43例(男23例,女20例),B组41例(男27例,女14例);其中A组39例(男21例,女18例),B组37例(男25例,女12例)完成12周观察.两组基线情况及生活质量评分等均无显著差异,具有可比性.运动12周后,A组患者总体和男、女性腰围均有显著降低[总体:(91±9)比(87±8) cm、男性:(93±8)比(88±6) cm、女性:(90±10)比(85±9) cm,t=4.454、2.232、4.430,均P<0.05].B组患者高密度脂蛋白胆固醇(HDL-C)有显著提高(t=-2.470,P<0.05).运动12周后,A组患者总体健康、活力、精神健康三方面有显著改善(t=-5.475、-3.897、-5.241,均P<0.05).B组患者生理功能、总体健康、活力、精神健康均有显著改善(t=-2.073、-3.506、-3.777、-3.215,均P<0.05).协方差分析显示,运动后两组患者血糖、血脂及生活质量评分差异均无统计学意义.A组的腰围及体脂百分比明显低于B组(F=544.982、545.049,均P<0.05).结论每日至少运动0.5 h可明显改善T2DM患者腹型肥胖,提高患者的生活质量,在总体健康、活力和精神健康方面更为显著.而每日至少1 h的运动则可显著改善糖尿病患者HDL-C水平.

abstractsObjective To observe the effect of different exercise intensity on quality of life in patients with type 2 diabetes. Methods Eighty four patients with type 2 diabetes were selected since July 2013 to November 2014, and were divided into 2 groups by sequence number:group A and B. Assessments of quality of life were conducted with the MOS 36 item short form health survey(SF-36) in all patients. Heart rate corresponding to 40%-60%of maximum oxygen consumption was set as target heart rate. Group A and B exercised half an hour and one hour a day respectively. The changes of metabolic indices, body fat percentage and quality of life in the two groups after 12 weeks of exercise were recorded and compared between the two groups. The enumeration data were compared with χ2 test between the two groups. Results Total of 43 cases (23 males and 20 females) and 41 patients(27 males and 14 females) were enrolled in group A and group B respectively;and 39 cases(21 males and 18 females) and 37 cases(25 males and 12 females) finished the study in the two groups respectively. There was no significant differences in all the baseline indexes between the two groups. Compared with those before exercise, waist circumference in all the subjects and in males and females in group A reduced significantly after exercise for 12 weeks(in all:(91±9) vs (87±8) cm, in male:(93±8) vs (88±6) cm, in female:(90±10) vs (85±9) cm, t=4.454, 2.232, 4.430, all P<0.05). In group B, the high density lipoprotein-cholesterol(HDL-C) increased significantly after exercise (t=-2.470, P<0.05). Compared with those before exercise, the general health, vitality and mental health in quality of life in group A increased significantly after 12 weeks of exercise (t=-5.475, -3.897,-5.241, all P<0.05). Physical function, general health, vitality and mental health of group B after exercise improved significantly too(t=-2.073,-3.506,-3.777,-3.215, all P<0.05). After 12 weeks of exercise, no statistical difference was found in blood glucose, blood lipid and quality of life score between group A and group B on the analysis of covariance. Waist circumference and body fat percentage of group A reduced significantly when compared with group B after the study(F=544.982, 545.049, P<0.05). Conclusions Taking exercise at least half an hour a day can improve obdominal obesity and quality of life in patients with type 2 diabetes, especially in terms of general health,vitality and mental health. One hour of exercise a day can increase the serum level of HDL-C in those patients.