López Varela María Victorina, Anido Turquesa, Larrosa María
Departamento de Neumología, Centro de Asistencia del Sindicato Médico del Uruguay (CASMU), Montevideo, Uruguay.
Arch Bronconeumol. 2006 Sep;42(9):434-9. doi: 10.1016/s1579-2129(06)60565-x.
To study functional status and survival in patients with chronic obstructive pulmonary disease (COPD) following a pulmonary rehabilitation program.
We assessed lung function, 6-minute walk distance, Borg score for dyspnea upon completion of the 6-minute walk, workload in watts on a cycle ergometer, quality of life using the St George's Respiratory Questionnaire (SGRQ); the body-mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index; and survival.
One hundred five patients participated in the pulmonary rehabilitation program. The patients had a mean (SD) age of 63.9 (9.3) years, body mass index of 24.5 (4.56) kg/m2, and forced expiratory volume in 1 second (FEV1) of 0.91 (0.46) L. The mean distances walked in 6 minutes were 412.8 (79.4) m before the pulmonary rehabilitation program and 443.46 (81.57) m after rehabilitation. The mean workloads on the cycle ergometer before and after rehabilitation, respectively, were 47.9 (29.6) W and 77.76 (20.88) W. The mean Borg scores were 2.2 (1.37) before and 1.47 (1.37) after rehabilitation, and the SGRQ scores at the same times were 27.63 (16.02) and 25.45 (15.12). Mortality due to respiratory disease (105 months) was 19%. Cumulative survival rates at 1 year, 3 years, and 6 years were 91%, 86.7%, and 6.75%, respectively. Survival was related to an FEV1 greater than 1.02 L (P = .05), a 6-minute walk distance over 448 m before rehabilitation (P = .04) and 454 m after rehabilitation (P = .05), and a workload on the cycle ergometer of over 54 W before rehabilitation (P = .01) and 72 W (P = .02) afterwards. The correlations between survival and both SGRQ and BODE scores were weaker.
We observed improved exercise capacity, dyspnea ratings, and, to a lesser extent, better SGRQ scores in our COPD patients following pulmonary rehabilitation. The best predictors of survival were FEV1, the 6-minute walk distance, and the cycle ergometer workloads.
研究慢性阻塞性肺疾病（COPD）患者在接受肺康复计划后的功能状态和生存率。
我们评估了肺功能、6分钟步行距离、6分钟步行结束时的呼吸困难Borg评分、蹬车测力计上的瓦特工作量、使用圣乔治呼吸问卷（SGRQ）评估的生活质量；体重指数、气流阻塞、呼吸困难和运动能力（BODE）指数；以及生存率。
105例患者参加了肺康复计划。患者的平均（标准差）年龄为63.9（9.3）岁，体重指数为24.5（4.56）kg/m²，第1秒用力呼气量（FEV1）为0.91（0.46）L。肺康复计划前6分钟的平均步行距离为412.8（79.4）m，康复后为443.46（81.57）m。康复前后蹬车测力计上的平均工作量分别为47.9（29.6）W和77.76（20.88）W。平均Borg评分康复前为2.2（1.37），康复后为1.47（1.37），同期SGRQ评分分别为27.63（16.02）和25.45（15.12）。呼吸系统疾病导致的死亡率（105个月）为19%。1年、3年和6年的累积生存率分别为91%、86.7%和6.75%。生存率与FEV1大于1.02 L（P = 0.05）、康复前6分钟步行距离超过448 m（P = 0.04）和康复后超过454 m（P = 0.05）以及康复前蹬车测力计工作量超过54 W（P = 0.01）和康复后超过72 W（P = 0.02）有关。生存率与SGRQ和BODE评分之间的相关性较弱。
我们观察到，COPD患者在接受肺康复后运动能力、呼吸困难评分有所改善，生活质量在一定程度上也有所提高。生存率最佳的预测指标是FEV1、6分钟步行距离和蹬车测力计工作量。
