慢性阻塞性肺疾病骨骼肌功能障碍的机制及康复干预研究进展  

Advances in pathogenic mechanisms and pulmonary rehabilitation strategies for skeletal muscle dysfunction in chronic obstructive pulmonary disease

作　　者：吴璐璐[1] 何薇[1] 林范杰 谢元昉 都韵霏 卢文菊[1] Wu Lulu;He Wei;Lin Fanjie;Xie Yuanfang;Du Yunfei;Lu Wenju(State Key Laboratory of Respiratory Disease,National Clinical Research Center for Respiratory Disease,Guangzhou Institute of Respiratory Health,the First Affiliated Hospital,Guangzhou Medical University,Guangzhou 510180,China)

机构地区：[1]广州医科大学附属第一医院、国家呼吸医学中心、国家呼吸系统疾病临床医学研究中心、呼吸疾病全国重点实验室、广州呼吸健康研究院,广州510180

出　　处：《中华结核和呼吸杂志》2024年第12期1163-1169,共7页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家自然科学基金(82330002);呼吸疾病全国重点实验室资助课题(SKLRD-Z-202420)。

摘　　要：慢性阻塞性肺疾病(简称慢阻肺)发病率、致死率高。骨骼肌功能障碍是影响慢阻肺患者预后的重要肺外并发症,其发病机制多种多样,早期诊断、早期干预有利于改善患者预后。肺康复是骨骼肌功能障碍最主要的干预方法。本文就慢阻肺骨骼肌功能障碍机制及康复策略最新进展进行简要综述。Chronic obstructive pulmonary disease(CoPD)is a complex heterogeneous chronic respiratory disease and third leading cause of death worldwide.In addition to damage to the respiratory system,coPD has significant extra-pulmonary effects,of which skeletal muscle dysfunction is one of the most prominent.Skeletal muscle dysfunction in CoPD can manifest as impaired muscle strength,loss of muscle mass,or decreased endurance,etc.Possible pathogenic mechanisms include abnormal neuro-muscular stimulation,dysregulated protein synthesis,hypoxia,inflammation,oxidative stress,mitochondrial dysfunction,impaired regenerative capacity,etc.Pulmonary rehabilitation(PR)can improve limb muscle function,exercise tolerance and quality of life of COPD patients.Exercise training is usually the main component of any PR program.Currently,PR is the main intervention for skeletal muscle dysfunction in COPD and could be executed in PR center,at home,or in the community using state-of-the-art technology.In this review,we summarized recent advances in pathogenic mechanisms and pulmonary rehabilitation strategies for skeletal muscle dysfunction in CoPD,in particular exercise training protocols,respiratory support and feedbackin PR,and so on.

关 键 词：骨骼肌功能障碍 慢性阻塞性肺疾病 肺外并发症 慢阻肺 康复干预 肺康复 早期诊断 发病机制 

分 类 号：R563.9[医药卫生—呼吸系统]