心肺康复运动训练对老年COPD康复期患者肺功能和心率变异性的影响  

Effects of cardiopulmonary rehabilitation exercise training on pulmonary function and heart rate variability in elderly patients with COPD during rehabilitation

作　　者：龚巧鹭 雷倩[1] 曾佳[1] 李娜[1] 屈云[1] Gong Qiaolu;Lei Qian;Zeng Jia;Li Na;Qu Yun(Key Laboratory of Rehabilitation Medicine of Sichuan Province,Department of Rehabilitation Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan,610031,P.R.China)

机构地区：[1]四川大学华西医院康复医学科,康复医学四川省重点实验室,四川成都610031

出　　处：《老年医学与保健》2021年第3期555-558,共4页Geriatrics & Health Care

基　　金：国家重点研发科研课题(2017YFC1308504)。

摘　　要：目的探讨心肺康复运动训练对老年慢性阻塞性肺疾病(COPD)康复期患者肺功能和心率变异性的影响。方法选取2017年10月-2019年10月在四川大学华西医院就诊的96例COPD患者,用随机数表法分为观察组(n=48)和对照组(n=48),对照组给予常规药物治疗,观察组在对照组的治疗方案基础上联合心肺康复运动训练。比较2组干预前后动脉血气功能指标、肺功能指标、心率变异性、运动能力。结果干预后12周,观察组pH值、血氧分压(PaO_(2))、用力肺活量(FVC)、第1秒用力呼气量(FEV 1)、FEV 1/FVC、二氧化碳分压(PaCO_(2))差值的绝对值高于对照组(P<0.05)。干预12后周,24h动态心电图监测显示,观察组RR间期的标准差(SDNN)、平均值的标准差(SDANN)、均方根(RMSSD)均高于对照组(P<0.05)。干预后12周,运动心肺功能测试显示,观察组的运动恢复期最大摄氧量(VO_(2)max)、无氧阈(AT)、最大运动负荷(MWL)水平高于对照组(P<0.05)。结论心肺康复运动训练可改善老年COPD患者的肺功能、肺动脉血气功能、心率变异性指标,显著提升其运动能力。Objective To explore the effects of cardiopulmonary rehabilitation exercise training on pulmonary function and heart rate variability(HRV)in elderly patients with chronic obstructive pulmonary disease(COPD)during rehabilitation.Methods A total of 96 patients with COPD treated in West China Hospital of Sichuan University from October 2017 to October2019 were enrolled.According to random number table method,they were divided into control group and observation group,48 cases in each group.The control group received conventional drug treatment,and the observation group received cardiopulmonary rehabilitation exercise training on the basis of the treatment plan of the control group.The arterial blood gas function indexes,pulmonary function indexes,HRV and exercise ability before and after intervention were compared between the two groups.Results After 12 weeks of intervention,pH value,partial pressure of blood oxygen(PaO_(2)),forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC and absolute value of partial pressure of carbon dioxide(PaCO_(2))difference value of the observation group were higher than those of the control group(P<0.05).After 12 weeks of intervention,24 h dynamic electrocardiogram monitoring showed that the standard deviation of the RR interval(SDNN),standard deviation of the mean of the RR interval(SDANN),root mean square of the RR interval(RMSSD)of the observation group were higher than those of the control group(P<0.05).After 12 weeks of intervention,cardiopulmonary exercise testing showed that the levels of the maximum oxygen uptake(VO_(2)max),anaerobic threshold(AT)and maximum exercise load(MWL)during exercise recovery of the observation group were higher than those of the control group(P<0.05).Conclusion Cardiopulmonary rehabilitation exercise training can improve the pulmonary function,pulmonary artery blood gas,and HRV of elderly COPD patients,and significantly enhance their exercise capacity..

关 键 词：老年 慢性阻塞性肺疾病 心肺康复运动训练 心率变异性 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]