Rammaert B, Leroy S, Cavestri B, Wallaert B, Grosbois J-M
Service de pneumologie et immuno-allergologie, centre de compétence maladies orphelines pulmonaires, clinique des maladies respiratoires, hôpital A.-Calmette, CHRU, boulevard du Pr-Leclercq, 59037 Lille cedex, France.
Rev Mal Respir. 2011 Sep;28(7):e52-7. doi: 10.1016/j.rmr.2011.06.006. Epub 2011 Jul 30.
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 programme over 10 months in stable patients suffering from IPF. Exercise capacity, pulmonary function, dyspnoea and quality of life were analyzed before and after the rehabilitation programme.
Seventeen patients were included and 13 completed the study. Mean functional vital capacity (FVC) was 2.15±0.79L and mean diffusing capacity for carbon monoxide (DLCO) was 7.81±3.99mL/min/mmHg. Six patients were treated with low dose oral steroids (20mg/day of prednisone) with or without immunosuppressive treatments; six 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 steps per minute on a stepper (322±97 vs. 456±163; P=0.026), six-minute walk distance relative to heart rate (HR) (11±6 vs. 17±12; P=0.006), exercise dyspnoea (P=0.026), sensation of physical limitation on the SF-36 (25%±26 vs. 49%±38; P=0.047) and four out of seven visual analogue scales were significantly improved after rehabilitation. In contrast, no significant difference was observed in resting pulmonary function or in other items on quality of life questionnaires.
A home-based programme of pulmonary rehabilitation is feasible in IPF patients. It significantly improved 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。肺康复可以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。平均功能性肺活量（FVC）为2.15±0.79L，平均一氧化碳弥散量（DLCO）为7.81±3.99mL/min/mmHg。6例患者接受低剂量口服类固醇（泼尼松20mg/天）治疗，有无免疫抑制治疗；6例患者参加治疗试验。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）、每分钟踏台上的步数（322±97对456±163；P = 0.026）、相对于心率（HR）的6分钟步行距离（11±6对17±12；P = 0.006）、运动性呼吸困难（P = 0.026）、SF-36上的身体受限感（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中的其他项目没有观察到显著差异。
居家肺康复计划对IPF患者是可行的。它显著改善了该患者群体的耐力参数和身体受限情况，而不改变肺功能。
