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强直性脊柱炎患者肺功能与运动能力及生活质量的关系

[The relationship between pulmonary function and exercise capacity and quality of life in patients with ankylosing spondylitis].

作者信息

Akyol Gonca, Özalevli Sevgi, Uçan Eyüp Sabri

机构信息

School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey.

出版信息

Tuberk Toraks. 2013;61(3):227-34. doi: 10.5578/tt.4272.

Abstract

INTRODUCTION

Ankylosing spondylitis causes restrictive respiratory disorder by limiting the expansion of the chest because of the costosternal and costovertebral joints. Our study is planned to evaluate the respiratory functions of the ankylosing spondylitis patients who have a high rate of pulmonary involvement, and to compare the results with the exercise capacity and life quality of these patients.

MATERIALS AND METHODS

There were 27 (18 male, 9 female) Norvegian patients who came to Turkey and had ankylosing spondylitis diagnose according to Modified New York criterias, to have a routine physical therapy and rehabilitation programme with an average age of 50.6 ± 6.6 years. The patients' clinical histories were taken. Pulmonary function tests were performed with spirometry and pulmonary muscle strength was measured with mouth pressure measure. 6 minute walk test was performed to determine exercise capacity and Short Form-36 Life Quality Questionairre was used to evaluate life quality of the patients.

RESULTS

The patients had 18.85 ± 10.64 average diagnose duration and the expected FEV1 value of the patients was 3.75 ± 0.88 L/sec, FEV1/FVC ratio was 80.44 ± 6.42, MIP was 62.96 ± 20.61 and MEP was 80.22 ± 21.12. 40.7% of the patients had positive smoking history while 14.8 % had dyspnea and 11.1% had symptoms of caughing-sputum. Walking distance was 595.50 ± 83.20 metre. Life quality category scores were 42.82 ± 16.78 minimally, 83.58 ± 23.06 maximally. Pulmonary function and pulmonary muscle strength values were similar in smoking and non-smoking patients. But in smoking patients, physical function and social function categories of quality of life survey scores were found lower than non-smoking patients.

CONCLUSION

Respiratory and other parameters were high related to high standarts in treatment and following and exercise habit of the patients in Norway. Accordingly, it is thought that an appropriate medical treatment and exercise as a lifestyle habits of the patients reduce the negative effects of ankylosing spondylitis on respiratory system.

摘要

引言

强直性脊柱炎由于肋胸关节和肋椎关节受限而导致胸廓扩张受限,进而引起限制性呼吸障碍。我们的研究旨在评估肺部受累率较高的强直性脊柱炎患者的呼吸功能,并将结果与这些患者的运动能力和生活质量进行比较。

材料与方法

有27名(18名男性,9名女性)挪威患者来到土耳其,根据改良纽约标准被诊断为强直性脊柱炎,平均年龄为50.6±6.6岁,接受常规物理治疗和康复计划。记录患者的临床病史。通过肺活量测定法进行肺功能测试,并用口腔压力测量法测量肺肌肉力量。进行6分钟步行试验以确定运动能力,并使用简短健康调查问卷36项版来评估患者的生活质量。

结果

患者的平均诊断时长为18.85±10.64年,患者的预计第一秒用力呼气容积(FEV1)值为3.75±0.88升/秒,FEV1/用力肺活量(FVC)比值为80.44±6.42,最大吸气压(MIP)为62.96±20.61,最大呼气压(MEP)为80.22±21.12。40.7%的患者有阳性吸烟史,14.8%的患者有呼吸困难,11.1%的患者有咳嗽咳痰症状。步行距离为595.50±83.20米。生活质量类别评分最低为42.82±16.78,最高为83.58±23.06。吸烟患者和非吸烟患者的肺功能和肺肌肉力量值相似。但在吸烟患者中,生活质量调查评分的身体功能和社会功能类别低于非吸烟患者。

结论

呼吸及其他参数与挪威患者的高标准治疗、随访及运动习惯高度相关。因此,认为适当的药物治疗和作为患者生活方式习惯的运动可减少强直性脊柱炎对呼吸系统的负面影响。

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