Stav David, Raz Meir, Shpirer Isaac
Pulmonary Institute, Tel Aviv University, Assaf Harofeh Medical Center, Zerrifin, Israel.
BMC Pulm Med. 2009 May 30;9:26. doi: 10.1186/1471-2466-9-26.
Pulmonary rehabilitation is known to be a beneficial treatment for COPD patients. To date, however, there is no agreement for how long a rehabilitation program should be implemented. In addition, current views are that pulmonary rehabilitation does not improve FEV1 or even slow its decline in COPD patients. The aim of the study was to examine the efficacy of a 3 year outpatient pulmonary rehabilitation (PR) program for COPD patients on pulmonary function, exercise capability, and body mass index (BMI).
A matched controlled trial was performed with outcome assessments evaluated at 6, 12, 18, 24, 30, and 36 months. Eighty patients with moderate to severe COPD (age 63 +/- 7 years; FEV1 48% +/- 14) were recruited. The control group received standard care only, while in addition, the case study group received PR for duration of three years. These groups were matched for age, sex, BMI, FEV1% and number of pack-years smoked.
The decline in FEV1 after the three years was significantly lower in the PR group compared to control, 74 ml versus 149 ml, respectively (p < 0.001). Maximal sustained work and endurance time improved after a short period of PR and was maintained throughout the study, in contrast to the control group (p < 0.01). A decreased BMI was noted in the control group after three years, while in the PR group a mild improvement was seen (p < 0.05).
Three years of outpatient pulmonary rehabilitation resulted in modifying the disease progression of COPD, as well as improving physical performance in these patients.
肺康复被认为是慢性阻塞性肺疾病（COPD）患者的一种有益治疗方法。然而，迄今为止，对于康复计划应实施多长时间尚无共识。此外，目前的观点认为肺康复并不能改善COPD患者的第一秒用力呼气容积（FEV1），甚至不能减缓其下降速度。本研究的目的是检验一项为期3年的门诊肺康复（PR）计划对COPD患者肺功能、运动能力和体重指数（BMI）的疗效。
进行了一项配对对照试验，在6、12、18、24、30和36个月时进行结果评估。招募了80例中度至重度COPD患者（年龄63±7岁；FEV1为48%±14）。对照组仅接受标准护理，而病例研究组除标准护理外还接受了为期三年的PR。这些组在年龄、性别、BMI、FEV1%和吸烟包年数方面进行了匹配。
与对照组相比，PR组三年后FEV1的下降明显更低，分别为74毫升和149毫升（p<0.001）。与对照组相比，短期PR后最大持续工作量和耐力时间有所改善，并在整个研究过程中保持（p<0.01）。三年后对照组的BMI下降，而PR组则有轻微改善（p<0.05）。
三年的门诊肺康复可改变COPD的疾病进展，并改善这些患者的身体表现。
