摘要
目的 探讨心率储备(HRR)指导慢性阻塞性肺疾病(COPD)稳定期患者进行快速步行亚极量运动康复的可行性和临床治疗价值。方法 前瞻性选取上海市浦东新区人民医院2016年10月至2019年3月收治的90例稳定期COPD患者,以随机数字表法分为3组:康复1组(n=30)、康复2组(n=30)和对照组(n=30)。康复1组进行达到60%~75%HRR的快速步行运动训练,康复2组保持主观感受Borg指数4~5分进行快速步行运动训练。训练持续24周,每周3次。对照组自行安排肺康复,不提供康复指导。比较三组患者康复训练完成情况、康复前后静息肺功能、心肺运动试验和COPD评估测试(CAT)评分。结果 90例患者中,82例(91. 1%)完成试验,其中康复1组27例,康复2组27例,对照组28例,3组间差异无统计学意义(P> 0. 05)。康复1组平均快速步行训练运动量高于康复2组,差异具有统计学意义(P <0. 05)。3组患者康复前后用力肺活量占预计值百分比(FVC%pred)、第1秒用力呼气容积占预计值百分比(FEV1%pred)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)差异均无统计学意义(P> 0. 05)。康复1组和康复2组患者康复后的深吸气量占预计值百分比(IC%pred)较康复前有显著改善,差异具有统计学意义(P <0. 05)。康复1组和康复2组患者康复后峰值摄氧量占预计值百分比(peak v O2%pred)、CAT评分较康复前均有显著改善,差异具有统计学意义(P <0. 05),但两组的改善程度差异无统计学意义(P> 0. 05)。康复1组患者的无氧阈占预计值百分比(AT%pred)、无氧阈(AT)时间康复前后的差异具有统计学意义(P <0. 05)。结论 COPD稳定期患者达到60%~75%HRR快速步行亚极量训练,可获得运动能力和生活质量的改善,延迟无氧阈,是可行有效的。
Objective To explore the feasibility and clinical value of heart rate reserve(HRR)in guiding fast walking sub-maximum rehabilitation training for patients with chronic obstructive pulmonary disease(COPD)in stable phase.Methods 90 patients with stable COPD who were treated in Pudong New Area People's Hospital of Shanghai from October 2016 to March 2019 were enrolled in this prospective study and assigned to rehabilitation group 1(n=30),rehabilitation group 2(n=30)and control group(n=30)by random number table method.Rehabilitation group 1 received fast walking training reaching 60%to 75%HRR.Rehabilitation group 2 received fast walking training maintaining subjective Borg 4-5 points.The training lasted 24 weeks,three times a week.Control group arranged pulmonary rehabilitation by themselves without rehabilitation guidance.The completion of rehabilitation training,resting pulmonary function,cardio-pulmonary exercise test and COPD assessment test(CAT)scores before and after rehabilitation were compared among three groups.Results Among the 90 patients,82(91.1%)completed the study(27 in rehabilitation group 1,27 in rehabilitation group 2 and 28 in control group).There was no significant difference among the three groups(P>0.05).The average exercise amount of fast walking training in rehabilitation group 1 was higher than that in rehabilitation group 2,and the difference was statistically significant(P<0.05).There was no significant difference in forced vital capacity percent of predicted(FVC%pred),forced expiratory volume in 1 second percent of predicted(FEV 1%pred),and FEV 1/FVC ratio in three groups before and after rehabilitation(P>0.05).After rehabilitation,the inspiratory capacity percentage of predicted(IC%pred)of rehabilitation group 1 and rehabilitation group 2 was significantly improved,and the difference was statistically significant(P<0.05).The peak oxygen uptake percentage of predicted(peak v O 2%pred)and CAT score of rehabilitation group 1 and rehabilitation group 2 were significantly improved compared with
作者
王林宣
顾文超
吴浩
杨华
奚峰
李珊珊
冯慧丽
WANG Lin-xuan;GU Wen-chao;WU Hao(Department of Respiration,Pudong New Area People's Hospital of Shanghai,Shanghai 201200,China)
出处
《临床和实验医学杂志》
2019年第24期2655-2659,共5页
Journal of Clinical and Experimental Medicine
基金
上海市浦东新区卫生和计划生育委员会卫生科技项目(编号:PW2016B-13)
上海市科技创新行动计划支持项目(编号:19ZR1447300)
关键词
慢性阻塞性肺疾病
心率储备
心肺运动试验
康复
Chronic obstructive pulmonary disease
Heart rate reserve
Cardiopulmonary exercise test
Rehabilitation
