摘要
目的探讨基于k-means聚类方法的分类肺康复对慢性阻塞性肺疾病(COPD)稳定期患者的干预效果。方法选取2018年1—6月在大同市第五人民医院呼吸科就诊的242例COPD稳定期患者,收集其一般资料〔包括年龄、病程、基础疾病种类、体质指数(BMI)、急性加重次数〕、肺功能指标〔包括第1秒用力呼气容积与用力肺活量比值(FEV_1/FVC)、第1秒用力呼气容积占预计值的百分比(FEV_1%pred)〕、6分钟步行距离(6MWD)、呼吸困难情况〔包括改良英国医学研究学会呼吸困难指数(mMRC)评分、呼吸困难次数〕、营养受损评分、慢性阻塞性肺疾病评估测试量表(CAT)评分、焦虑自评量表(SAS)评分及日常生活能力量表(ADL)评分。采用k-means聚类方法确定本组COPD稳定期患者最佳分类为3类,之后在第1类COPD稳定期患者中随机选取30例作为A1组、30例作为B1组,在第2类COPD稳定期患者中随机选取30例作为A2组、30例作为B2组,在第3类COPD稳定期患者中随机选取30例作为A3组、30例作为B3组。A1组、A2组及A3组患者给予常规康复方案,B1组、B2组及B3组患者给予基于k-means聚类方法的分类肺康复;六组患者均连续干预6个月。比较A1组与B1组患者干预前后肺功能指标和6MWD,A2组与B2组患者干预前后急性加重次数、肺功能指标、6MWD及mMRC评分,A3组与B3组患者干预前后肺功能指标、6MWD、mMRC评分、营养受损评分、CAT评分及SAS评分。结果 (1)A1组与B1组患者干预前FEV_1/FVC、FEV_1%pred、6MWD及干预后FEV_1/FVC、FEV_1%pred比较,差异无统计学意义(P>0.05);B1组患者干预后6MWD长于A1组(P<0.05)。(2)A2组与B2组患者干预前急性加重次数、FEV1/FVC、FEV1%pred、6MWD、mMRC评分及干预后FEV_1/FVC、FEV_1%pred、6MWD比较,差异无统计学意义(P>0.05);B2组患者干预后急性加重次数少于A2组,mMRC评分低于A2组(P<0.05)。(3)A3组与B3组患者干预前FEV_1/FVC、FEV_1%pred、6MWD、m MRC评分�
Objective To investigate the intervention effect of classified pulmonary rehabilitation based on k-means clustering method on patients with stable chronic obstructive pulmonary disease(COPD).Methods From January to June 2018,a total of 242 stable COPD patients were selected in the Department of Respiration,the Fifth People's Hospital of Datong,the general information(including age,disease course,kinds of underlying diseases,BMI,number of acute exacerbation),indexes of pulmonary function(including FEV1/FVC and FEV1%pred),6MWD,dyspnea status(including mMRC score and number of dyspnea),nutritional impairment score,CAT score,SAS score and ADL score were collected.Optimal classification of the 242 stable COPD patients were divided into three crowds by k-means clustering method,after that 30 patients were randomly selected as A1 group and 30 patients as B1 group in the first classified stable COPD patients,30 patients were randomly selected as A2 group and 30 patients as B2 group in the second classified stable COPD patients,30 patients were randomly selected as A3 group and 30 patients as B3 group in the third classified stable COPD patients.Patients in groups A1,A2 and A3 were treated received routine rehabilitation program,while patients in groups B1,B2 and B3 received classified pulmonary rehabilitation based on k-means clustering method,all of the 6 groups were continuously intervened for 6 months.Indexes of pulmonary function and 6MWD were compared between A1 group and B1 group before and after intervention,number of acute exacerbation,indexes of pulmonary function,6MWD and mMRC score were compared between A2 group and B2 group before and after intervention,meanwhile indexes of pulmonary function,6MWD,mMRC score,nutritional impairment score,CAT score and SAS score were compared between A3 group and B3 group before and after intervention.Results(1)There was no statistically significant difference in FEV1/FVC,FEV1%pred or 6MWD between groups A1 and B1 before intervention(P>0.05);6MWD in B1 group was statistically s
作者
李彩平
李海荣
夏仲年
常冰梅
曹锡梅
LI Caiping;LI Hairong;XIA Zhongnian;CHANG Bingmei;CAO Ximei(Shanxi Medical University,Taiyuan 030001,China;Teaching and Research Office of Histoembryology,Shanxi Medical University,Taiyuan 030001,China;Department of Human Anatomy,Shanxi Medical University,Taiyuan 030001,China;Department of Biochemistry and Molecular Biology,Shanxi Medical University,Taiyuan 030001,China)
出处
《实用心脑肺血管病杂志》
2019年第9期50-55,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
2018年山西省自然科学基金面上项目(201801D121310)
关键词
慢性阻塞性肺疾病
稳定期
肺康复
聚类分析
Chronic obstructive pulmonary disease
Stable stage
Pulmonary rehabilitation
Cluster analysis
