摘要
目的观察集束化肺康复治疗对中重度稳定期慢性阻塞性肺疾病(COPD)患者的静态肺功能、心肺运动功能、相关炎性因子的影响。方法选择2017年12月至2018年10月大连大学附属中山医院60例COPD患者(中重度稳定期),按随机数字表法分为对照组和康复组,每组各30例。对照组给予常规内科治疗,康复组除了给予常规内科治疗外,同时给予集束化肺康复治疗。最终观察两组患者治疗前、治疗后3和6个月的肺功能、心肺运动功能、炎性因子的水平。结果对照组肺功能[第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值百分比(FEV1%pred)、第1秒用力呼气容积占用力肺活量(FVC)的百分比(FEV1/FVC)]、心肺运动功能[峰值运动功率(peak load)、峰值摄氧量(peak VO2)、峰值摄氧量占预计值的百分比(peak VO2%pred)、千克摄氧量(peak VO2/kg)、峰值分钟通气量(peak VE)],治疗后3、6个月较治疗前未见明显变化(P>0.05),康复组治疗后3个月较前一阶段未有改善(P>0.05),但治疗后6个月较治疗前及治疗后3个月均明显改善(P<0.05)。对照组C反应蛋白(CRP)和白细胞介素-6(IL-6)在治疗后3个月、肿瘤坏死因子-α(TNF-α)在治疗后3、6个月较治疗前均未见明显变化(P>0.05)。对照组治疗后6个月CRP、IL-6较治疗前及治疗后3个月时均下降[CRP:(5.48±0.91)mg/L比(6.26±0.99)、(6.09±0.97)mg/L,IL-6:(9.17±1.04)ng/L比(10.83±1.79)、(10.29±1.53)ng/L](P<0.05)。康复组治疗后3、6个月CRP、IL-6、TNF-α均较前一阶段明显下降[CRP:(5.21±0.87)、(5.67±0.91)mg/L比(6.15±0.92)mg/L,IL-6:(8.56±1.17)、(10.03±1.61)ng/L比(11.06±2.01)ng/L,TNF-α:(7.16±1.33)、(8.05±1.62)ng/L比(8.97±2.05)ng/L](P<0.05)。康复组治疗前后血清炎性因子CRP、IL-6、TNF-α与肺功能(FEV1、FEV1%pred、FEV1/FVC)、心肺运动功能(peak load、peak VO2、peak VO2%pred、peak VO2/kg、peak VE)呈显著负相关(r=-0.641^-0.884,P<0.01)。结论中重度稳定期COPD�
Objective To observe the effects of bundled pulmonary rehabilitation on static pulmonary function,cardiopulmonary exercise function and inflammatory factors in patients with moderate or severe stable chronic obstructive pulmonary disease(COPD).Methods Sixty moderate or severe COPD patients in stable phase from December 2017 to October 2018 in Affiliated Zhongshan Hospital of Dalian University were selected.The patients were divided into control group and rehabilitation group by random digits table with 30 cases each.The patients of control group received routine medicine therapy,and the patients of rehabilitation group received bundled pulmonary rehabilitation besides routine medicine therapy.Pulmonary function,cardiopulmonary exercise function and inflammatory factors in each group were tested before treatment and 3,6 month after treatment.Results In control group,there were no statistical differences in the pulmonary function,including the forced expired volume in one second(FEV1),FEV1 as percentage of predicted(FEV1%pred),FEV1/forced vital capacity(FVC);cardiopulmonary exercise function,including the peak load,peak VO2,peak VO2 as percentage of predicted(peak VO2%pred),peak VO2/kg,peak VE 3 and 6 months after treatment compared with those before treatment(P>0.05);in rehabilitation group,there were no statistical differences in the indexes 3 months after treatment compared with those before treatment(P>0.05),the indexes 6 months after treatment were significantly improved compared with those before treatment and 3 months after treatment(P<0.05).In control group,the C-reactive protein(CRP)and interleukin(IL-6)before treatment and 3 months after treatment and tumor necrosis factor-α(TNF-α)before treatment and 3,6 months after treatment had no significant difference(P>0.05);the CRP and IL-66 months after treatment were significantly lower than those before treatment and 3 months:(5.48±0.91)mg/L vs.(6.26±0.99)and(6.09±0.97)mg/L,(9.17±1.04)ng/L vs.(10.83±1.79)and(10.29±1.53)ng/L,P<0.05.In rehabilitation grou
作者
王涛
裴复阳
宋晓萍
刘婷
王红梅
孙莹
Wang Tao;Pei Fuyang;Song Xiaoping;Liu Ting;Wang Hongmei;Sun Ying(Department of Respiratory,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China)
出处
《中国医师进修杂志》
2020年第5期452-457,共6页
Chinese Journal of Postgraduates of Medicine
基金
大连市卫生健康委员会课题(1711107)。
关键词
肺疾病
慢性阻塞性
呼吸功能试验
集束化肺康复
心肺运动功能
Pulmonary disease
Chronic obstructive
Respiratory function tests
Bundled pulmonary rehabilitation
Cardiopulmonary exercise function
