呼吸康复锻炼对老年慢性阻塞性肺疾病患者运动心肺功能的影响  

The effects of respiratory rehabilitation training to cardiopulmonary exercise testing in geriatric patients with chronic obstructive pulmonary disease

作　　者：田银君[1] 刘前桂[1] 赵黎黎[1] 李金红[1] 赵双燕[1] 周苗子[1] 张媛[1] 

机构地区：[1]北京老年医院呼吸康复科,100095

出　　处：《国际呼吸杂志》2015年第13期978-983,共6页International Journal of Respiration

基　　金：北京老年医院科研基金资助项目（2012bjlnyy-自-3）

摘　　要：目的探讨呼吸康复锻炼对老年COPD稳定期患者运动心肺功能及症状改善的影响。方法97例稳定期老年COPD患者随机分为康复组55例和对照组42例，康复组除常规内科药物治疗外均进行12周的呼吸康复锻炼，对照组只采用常规内科药物治疗。2组患者治疗前及12周时均进行运动心肺试验、圣乔治呼吸问卷（SGRQ）及BODE评分。结果康复锻炼前后静态肺功能未见明显变化（P〉0．05）。康复组反应运动耐力和心功能的指标Wmax、VO2max、VO2max／kg、VO2／HR、HRR较自身康复前及对照组均显著改善（P〈0．01），反应通气功能的指标VEmax、VTmax、BR较自身康复前及对照组均显著增加（P〈0．01），反应气体交换的指标VD／VT@rest、VD／VT@peak较自身康复前及对照组均显著降低（P〈0．01），SGRQ评分及BODE指数较自身康复前及对照组均显著降低（P〈0．01）。对照组的Wmax前后对比平均降低（2．15±5．90）w（P〈0．05），其余指标前后对比差异无统计学意义（P〉0．05）。结论呼吸康复锻炼能显著改善老年COPD患者的有氧代谢能力和肺通气、换气水平，提高运动耐量及改善症状。Objective To explore the effects of respiratory rehabilitation training in geriatric patients with stable chronic obstructive pulmonary disease （COPD）, which focuse on the changes of cardiopulmonary exercise function and COPD symptoms. Methods Ninety-seven cases of geriatric patients with stable COPD were randomly divided into rehabilitation group of 55 cases and control group of 42 cases. All patients received conventional medical therapy. Meanwhile, the rehabilitation group received respiratory rehabilitation training for 12 weeks. The improvements of cardiopulmonary exercise test （CPET） ,St Georgers Respiratory Questionnaire （SGRQ） and BODE index were evaluated before and after the training scheme. Results There was no significant difference in resting spirometry after respiratory rehabilitation training （ P〉0.05）. The exercise tolerance and cardic function indexs such as Wmax,VO2 max, VO2 max/kg, VO2/HR and HRR were improved in rehabilitation group significantly than baseline and the control group （ P 〈0.01）. Ventilation indexs such as VEmax,VTmax and BR were elevated in rehabilitation group significantly than baseline and the control group （P 〈 0.01 ）. Gas exchange indexs such as VD/VT @ rest and VD/VT @ peak were decreased in rehabilitation group significantly than baseline and the control group （ P 〈0.01）. SGRQ and BODE index were decreased in rehabilitation group significantly than baseline and the control group （ P 〈0.01）. Wmax was decreased significantly in the control group than baseline （ P 〈0. 05） ,other indexs mentioned aboved of the controlgroup remained almost the same （ P〉 0.05）. Conclusions Respiratory rehabilitation training can markedly improve the level of aerobic capacity, pulmonary ventilation and Gas exchange response in geriatric patients with stable COPD,and then improve the exercise tolerance and symptoms.

关 键 词：慢性阻塞性肺疾病 呼吸康复锻炼 心肺运动试验 

分 类 号：R563.05[医药卫生—呼吸系统]