有氧抗阻运动联合多学科延续护理对糖尿病足高危者代谢、生活质量及Omentin-1的影响

Effects of Aerobic Resistance Exercise Combined with Multidisciplinary Continuous Nursing on Metabolism, Quality of Life and Omentin-1 in High-Risk Patients with Diabetes Foot

摘要: 目的：探讨有氧抗阻运动联合多学科延续护理对糖尿病足高危者代谢、生活质量及网膜素-1 (Omentin-1)的影响。方法：选择海南医学院第二附属医院2021年10月~2022年6月接诊的糖尿病足高危患者200例作为研究对象。采取随机数字表格的方法，把全部患者分为对照组以及干预组，每组均100名。分析2组患者干预前以及干预后的血糖相关指标(空腹及餐后2 h血糖、糖化血红蛋白)、血脂相关指标(低密度脂蛋白胆固醇、甘油三酯、总胆固醇)、血清网膜素-1 (Omentin-1)、生活质量[糖尿病生存质量特异性量表(DSQL)]、糖尿病足指标(足背动脉内径、足背动脉血流速度)。结果：干预前2组的空腹血糖、餐后2 h血糖、糖化血红蛋白、低密度脂蛋白胆固醇、甘油三酯、总胆固醇、Omentin-1、DSQL评分、足背动脉内径、足背动脉血流速度数据差异无统计学意义(均P > 0.05)。干预后，干预组的空腹血糖、餐后2 h血糖、糖化血红蛋白、低密度脂蛋白胆固醇、甘油三酯、总胆固醇、DSQL评分分别为(7.68 ± 1.08) mmol/L、(10.03 ± 1.20) mmol/L、(7.15 ± 1.07)%、(3.22 ± 0.35) mmol/L、(1.74 ± 0.24) mmol/L、(4.52 ± 0.50) mmol/L、(65.23 ± 8.48)分，低于对照组的(8.13 ± 1.14) mmol/L、(11.58 ± 1.74) mmol/L、(7.76 ± 0.85)%、(3.41 ± 0.48) mmol/L、(1.91 ± 0.29) mmol/L、(4.77 ± 0.72) mmol/L、(71.35 ± 8.56)分，数据差异有统计学意义(t = 2.026~5.185，均P < 0.05)。干预后，干预组的Omentin-1、足背动脉内径、足背动脉血流速度分别为(33.48 ± 4.69) μg/L、(2.11 ± 0.27) mm、(6.43 ± 0.96) cm/s，高于对照组的(29.58 ± 4.44) μg/L、(1.87 ± 0.22) mm、(5.72 ± 0.80) cm/s，数据差异有统计学意义(t = −6.891~−5.682，均P < 0.05)。结论：将有氧抗阻运动联合多学科延续护理的方法投入到糖尿病足患者的干预过程中，不仅有助于改善该类患者的血糖、血脂相关指标以及Omentin-1水平，同时可以提升该类患者的生活质量、改善糖尿病足的情况。

Abstract: Objective: To explore the effect of aerobic resistance exercise combined with multidisciplinary continuous nursing on metabolism, quality of life and omentin-1 in high-risk patients with diabetes foot. Methods: 200 high-risk patients with diabetes foot who were admitted to the Second Affiliated Hospital of Hainan Medical College from October 2021 to June 2022 were selected as the study subjects. All patients were randomly divided into control group and intervention group with 100 patients in each group. The blood glucose related indicators (fasting and 2 h postprandial blood glucose, glycosylated hemoglobin), blood lipid related indicators (low-density lipoprotein cholesterol, triglyceride, total cholesterol), serum omentin-1, quality of life [diabetes quality of life specificity scale (DSQL)], and diabetes foot indicators (dorsalis pedis artery diameter, dorsalis pedis artery blood flow velocity) of the two groups of patients were analyzed before and after the intervention. Results: There was no significant difference in fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin, low-density lipoprotein cholesterol, triglycerides, total cholesterol, Omentin-1, DSQL score, dorsalis pedis artery diameter, and dorsalis pedis artery blood flow velocity between the two groups before intervention (all P > 0.05). After intervention, the scores of fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin, low-density lipoprotein cholesterol, triglycerides, total cholesterol and DSQL in the intervention group were (7.68 ± 1.08) mmol/L, (10.03 ± 1.20) mmol/L, (7.15 ± 1.07)%, (3.22 ± 0.35) mmol/L, (1.74 ± 0.24) mmol/L, (4.52 ± 0.50) mmol/L, (65.23 ± 8.48) respectively, lower than those in the control group (8.13 ± 1.14) mmol/L, (11.58 ± 1.74) mmol/L, (7.76 ± 0.85)%, (3.41 ± 0.48) mmol/L, (1.91 ± 0.29) mmol/L, (4.77 ± 0.72) mmol/L, (71.35 ± 8.56) points; the data difference was statistically significant (t = 2.026~5.185, all P < 0.05). After intervention, the Omentin-1, the diameter of dorsalis pedis artery and the blood flow velocity of dorsalis pedis artery in the intervention group were (33.48 ± 4.69) respectively μG/L, (2.11 ± 0.27) mm, (6.43 ± 0.96) cm/s, higher than (29.58 ± 4.44) in the control group μG/L, (1.87 ± 0.22) mm, (5.72 ± 0.80) cm/s; the data difference was statistically significant (t = −6.891~−5.682, all P < 0.05). Conclusion: Putting the method of aerobic resistance exercise combined with multidisciplinary continuous nursing into the intervention process of patients with diabetes foot will not only help to improve the blood sugar, lipid related indicators and the level of Omentin-1 in such patients, but also improve the quality of life of such patients and the condition of diabetes foot.