肺康复对稳定期中重度慢性阻塞性肺疾病老年患者血清细胞因子和抑郁情绪的影响  

Effect of pulmonary rehabilitation on the serum cytokine and depression of the elderly patients with chronic obstructive pulmonary disease

作　　者：方翔[1] 孙芳[1] 汤兵祥[1] 侯聪霞[1] 张春艳[1] 边红芝[1] Fang Xiang;Sun Fang;Tang Bingxiang;Hou Congxia;Zhang Chunyan;Bian Hongzhi(Department of Respiratory,Henan Province Chest Hospital,Zhengzhou 450008,China)

机构地区：[1]河南省胸科医院呼吸与危重症科,郑州450008

出　　处：《中国临床实用医学》2022年第1期25-29,共5页China Clinical Practical Medicine

基　　金：河南省医学科技攻关计划项目(LHGJ20190754)。

摘　　要：目的探讨肺康复对稳定期老年中重度慢性阻塞性肺疾病(COPD)患者血清细胞因子、抑郁的影响及细胞因子与抑郁的相关性。方法本研究为临床研究,选取2016年12月至2017年9月河南省胸科医院呼吸与危重症科收治的80例稳定期老年中重度COPD患者,男61例,女19例,年龄(68.13±5.14)岁,年龄范围为63~73岁。采用随机数表法将患者随机分为肺康复组和常规治疗组,每组40例。两组均给予COPD稳定期常规治疗。肺康复组在此基础上给予肺康复治疗,包括健康教育、营养指导、呼吸功能锻炼、上下肢锻炼。于治疗前、治疗12周、治疗24周时,分别测定两组患者白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、抑郁自评量表(CES-D)评分、6 min步行试验(6MWD)距离及肺功能指标[第一秒用力呼气容积(FEV1)%预计值、FEV1/用力肺活量(FVC)]。结果两组患者治疗前IL-6、TNF-α水平、FEV1%预计值、FEV1/FVC、CES-D评分及6MWD距离比较,差异均无统计学意义(P>0.05)。两组患者治疗12周及治疗24周的FEV1%预计值及FEV1/FVC比较,差异无统计学意义(P>0.05)。肺康复组患者治疗12周、治疗24周的IL-6[(26.35±2.27)pg/ml、(21.16±2.58)pg/ml]、TNF-α水平[(55.75±6.72)pg/ml、(48.39±6.97)pg/ml]及CES-D评分[(18.10±3.81)分、(14.88±3.02)分]均低于治疗前[(33.43±2.07)pg/ml、(64.64±7.47)pg/ml、(21.65±3.58)分],6MWD距离[(301.13±30.47)m、(357.10±29.41)m]多于治疗前[(277.28±31.12)m],差异有统计学意义(P<0.05)。常规治疗组患者治疗12周、治疗24周的IL-6、TNF-α水平、CES-D评分及6MWD距离与治疗前比较,差异无统计学意义(P>0.05)。肺康复组患者治疗12周、治疗24周的IL-6、TNF-α水平及CES-D评分均低于常规治疗组[(31.67±3.05)pg/ml、(31.18±3.65)pg/ml,(61.63±6.66)pg/ml、(61.70±5.80)pg/ml,(21.20±3.20)分、(19.90±3.56)分],6MWD距离多于常规治疗组[(274.19±24.65)m、(273.68±25.58)m],差异有统计学意义(P<0.05)。治疗前ILObjective To investigate the effect of pulmonary rehabilitation on serum cytokines and depression in elderly patients with moderate to severe chronic obstructive pulmonary disease(COPD)at stable stage and the correlation between cytokines and depression.Methods This study was a clinical study,80 elderly patients with moderate to severe COPD at stable stage were selected from the department of respiratory and critical care,henan chest hospital from December 2016 to September 2017,including 61 males and 19 females,aged(68.13±5.14)years old,and the age range was 63 to 73 years old.The patients were randomly divided into lung rehabilitation group and conventional treatment group using random number table method,with 40 cases in each group.Both groups were given routine treatment for COPD in stable phase.On this basis,the lung rehabilitation group was given lung rehabilitation therapy,including health education,nutrition guidance,respiratory function exercise,upper and lower limb exercise,etc.Before treatment,12 weeks and 24 weeks after treatment,the interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),self-rating depression scale(CES-D)scores,the 6-min walk test distance(6MWD),and lung function indexes[forced expiratory volume in first second(FEV1)%estimate,FEV1/forced vital capacity(FVC)]of the two groups were measured.Results There were no significant differences in the levels of IL-6,TNF-α,FEV1%estimated values,FEV1/FVC,CES-D and 6MWD distance between the two groups before treatment(P>0.05).There was no statistically significant difference(P>0.05)when comparing FEV1%estimated value and FEV1/FVC between the two groups of patients at 12 weeks of treatment and 24 weeks of treatment.In the lung rehabilitation group,IL-6[(26.35±2.27)pg/ml,(21.16±2.58)pg/ml],TNF-αlevel[(55.75±6.72)pg/ml,(48.39±6.97)pg/ml]and CES-D scores[(18.10±3.81)scores,(14.88±3.02)scores]were found after 12 and 24 weeks of treatment,they were all lower than those before treatment[(33.43±2.07)pg/ml,(64.64±7.47)pg/ml,(21.65±3.58)scores],an

关 键 词：肺康复 慢性阻塞性肺疾病 细胞因子 抑郁 

分 类 号：R563.9[医药卫生—呼吸系统]