有氧训练对稳定期COPD患者肺康复效果及机制探讨  

Effects and mechanism of aerobic training on pulmonary rehabilitation of COPD patients in stable stage

作　　者：王坤[1] 李雅薇[1] 王玉龙[1] Wang Kun;Li Yawei;Wang Yulong(Department of Rehabilitation Medicine,the First Affiliated Hospital of Shenzhen University,Shenzhen 518000,China)

机构地区：[1]深圳大学第一附属医院(深圳市第二人民医院)康复医学科,广东深圳518035

出　　处：《中国康复》2021年第3期162-165,共4页Chinese Journal of Rehabilitation

摘　　要：目的:观察有氧训练对慢性阻塞性肺疾病(COPD)稳定期患者肺康复效果,初步探讨其治疗机制。方法:选择COPD患者86例,按照随机数字表法分为观察组和对照组各43例。对照组接受COPD稳定期常规治疗,观察组在对照组治疗基础上予以有氧训练,共治疗12周。比较2组治疗前后心肺运动功能指标、白细胞介素-17(IL-17)、转化生长因子β1(TGF-β1)、IL-10、血管内皮生长因子(VEGF)、高迁移率族蛋白1(HMGB1)、碱性成纤维细胞生长因子(bFGF)和缺氧诱导因子-1α(HIF-1α)水平以及外周血Th17、Treg含量、Th17/Treg值。结果:治疗12周后,2组峰值摄氧量(PeakVO_(2))、最大每分钟通气量(VEmax)较治疗前均明显升高(均P<0.01),且观察组均更高于对照组(均P<0.01),但2组无氧阈时CO_(2)通气当量(VE/CO_(2)AT)较治疗前均明显降低(均P<0.01),且观察组更低于对照组(P<0.01)。2组IL-17、VEGF、HMGB1、bFGF、HIF-1α、Th17、Th17/Treg值较治疗前均明显降低(均P<0.01),且观察组均更低于对照组(均P<0.01),但2组TGF-β1、IL-10、Treg较治疗前均明显升高(均P<0.01),且观察组均更高于对照组(均P<0.01)。结论:有氧训练有利于调节Th17/Treg细胞亚群失衡,抑制炎症反应,延缓肺血管重塑,提高COPD患者的心肺运动功能。Objective:To explore the effect of aerobic training on pulmonary rehabilitation of patients with COPD in stable stage and the treatment mechanism.Methods:A total of 86 cases of COPD were selected according to the random number table method,the patients were divided into two groups with 43 cases in each group.The control group received conventional treatment of COPD during the stable period.The treatment group was given aerobic training on the basis of treatment in the control group.Before and after 12 weeks of treatment,cardiopulmonary function indicators,interleukin-17(IL-17),transforming growth factorβ1(TGF-β1),IL-10,vascular endothelial growth factor(VEGF),high mobility group protein 1(HMGB1),basic fibroblast growth factor(bFGF)and hypoxia-induced factor-1α(HIF-1α)levels,peripheral blood Th17 and Treg contents,and Th17/Treg value were compared between the two groups.Results:After 12 weeks of treatment,the peak VO_(2)and VEmax in the two groups were significantly higher than those before treatment(all P<0.01),and those in the treatment group were significantly higher than those in the control group(all P<0.01),but the VE/CO_(2)at anaerobic threshold in the two groups was significantly lower than that before treatment(P<0.01),and that in the treatment group was significantly lower than that in the control group(P<0.01).The levels of IL-17,VEGF,HMGB1,bFGF,HIF-1α,Th17 and Th17/Treg after treatment in the two groups were significantly lower than those before treatment(all P<0.01),and those in the treatment group were significantly lower than those in the control group(all P<0.01),but the levels of TGF-β1,IL-10 and Treg in the two groups were significantly higher than those before treatment(all P<0.01),and those in the treatment group were significantly higher than those in the control group(all P<0.01).Conclusion:Aerobic training is beneficial to regulate Th17/Treg cell subgroup imbalance,inhibit inflammatory response,delay pulmonary vascular remodeling,and improve cardiopulmonary function in COPD patients.

关 键 词：慢性阻塞性肺疾病 有氧训练 血管重塑 心肺运动功能 

分 类 号：R49[医药卫生—康复医学] R563.8[医药卫生—临床医学]