Rammaert B, Leroy S, Cavestri B, Wallaert B, Grosbois J-M
Clinique des maladies respiratoires, Centre de compétence maladies orphelines pulmonaires, Hôpital Albert-Calmette, CHRU de Lille, France.
Rev Mal Respir. 2009 Mar;26(3):275-82. doi: 10.1016/s0761-8425(09)72584-7.
Idiopathic pulmonary fibrosis (IPF) is a severe chronic lung disease. Pulmonary rehabilitation could improve the quality of life of patients with this condition.
We prospectively evaluated the impact of an 8 week home-based pulmonary rehabilitation program over 10 months in stable patients suffering from IPF. Exercise capacity, pulmonary function, dyspnea and quality of life were analyzed before and after the rehabilitation program.
17 patients were included and 13 completed the study. Mean FVC was 2.15+/-0.79 L and mean DLCO was 7.81+/-3.99 ml/min/mmHg. Six patients were treated with low dose oral steroids ($20 mg/day of prednisone) with or without immunosuppressive treatments; 6 were taking part in therapeutic trials. Mean endurance time (7.4+/-9.1 min vs 14.1+/-12.1 min; p<0,01), number of beats per minute on a stepper (322+/-97 vs 456+/-163; p=0.026), 6 min walking distance to heart rate ratio (11+/-6 vs 17+/-12; p=0.006), exercise dyspnea (p=0.026), sensation of physical limitation at the SF-36 (25%+/-26 vs 49%+/-38; p=0.047) and 4 out of 7 visual analog scales were significantly improved after rehabilitation. In contrast, no significant difference was observed in resting pulmonary function or in other items of quality of life questionnaires
A home-based program of pulmonary rehabilitation is feasible in IPF patients. It significantly improves endurance parameters and physical limitation in this patient group without changing pulmonary function.
特发性肺纤维化（IPF）是一种严重的慢性肺部疾病。肺康复可改善患有这种疾病的患者的生活质量。
我们前瞻性地评估了一项为期8周的居家肺康复计划在10个月内对稳定期IPF患者的影响。在康复计划前后分析了运动能力、肺功能、呼吸困难和生活质量。
纳入17例患者，13例完成研究。平均用力肺活量（FVC）为2.15±0.79升，平均一氧化碳弥散量（DLCO）为7.81±3.99毫升/分钟/毫米汞柱。6例患者接受低剂量口服类固醇（泼尼松≤20毫克/天）治疗，有或没有免疫抑制治疗；6例参与治疗试验。康复后，平均耐力时间（7.4±9.1分钟对14.1±12.1分钟；p<0.01）、踏阶仪上每分钟心跳次数（322±97对456±163；p=0.026）、6分钟步行距离与心率比值（11±6对17±12；p=0.006）、运动性呼吸困难（p=0.026）、SF-36身体受限感（25%±26对49%±38；p=0.047）以及7个视觉模拟量表中的4个有显著改善。相比之下，静息肺功能或生活质量问卷的其他项目未观察到显著差异。
居家肺康复计划对IPF患者是可行的。它能显著改善该患者群体的耐力参数和身体受限情况，而不改变肺功能。
