Hornikx Miek, Van Remoortel Hans, Demeyer Heleen, Marcal Camillo Carlos Augusto, Decramer Marc, Janssens Wim, Troosters Thierry
Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium ; Respiratory Division and Rehabilitation, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
Respiratory Division and Rehabilitation, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
Biomed Res Int. 2013;2013:146148. doi: 10.1155/2013/146148. Epub 2013 Dec 26.
Chronic obstructive pulmonary disease (COPD) is associated with comorbidities such as cardiovascular disease, metabolic disease, osteoporosis, and anxiety and/or depression. Although pulmonary rehabilitation programs are proven to be beneficial in patients with COPD, it is unclear whether comorbidities influence pulmonary rehabilitation outcomes. The aim of the present review was to investigate to what extent the presence of comorbidities can affect pulmonary rehabilitation outcomes.
The systematic literature search (Pubmed, EMBASE, and PEDro) resulted in 4 articles meeting the inclusion criteria. The odds ratios (95% confidence intervals) of the logistic regression analyses, with comorbidities as independent variables and pulmonary rehabilitation outcomes (dyspnea, functional exercise capacity, and quality of life) as dependent variables, were used for data extraction.
Patients with anxiety and/or depression less likely improve in dyspnea. Osteoporosis is associated with less improvements in functional exercise capacity, while cardiovascular disease does not seem to negatively impact on this outcome. Patients with cardiovascular comorbidity will experience less positive changes in quality of life.
Evidence from literature suggests that comorbidities can have a negative influence on pulmonary rehabilitation outcomes. Screening for comorbidities in pulmonary rehabilitation settings seems useful to readdress the right patients for individually tailored pulmonary rehabilitation.
慢性阻塞性肺疾病（COPD）与心血管疾病、代谢性疾病、骨质疏松症以及焦虑和/或抑郁等合并症相关。尽管肺康复计划已被证明对COPD患者有益，但尚不清楚合并症是否会影响肺康复效果。本综述的目的是研究合并症的存在在多大程度上会影响肺康复效果。
通过系统的文献检索（PubMed、EMBASE和PEDro），筛选出4篇符合纳入标准的文章。以合并症为自变量，肺康复效果（呼吸困难、功能锻炼能力和生活质量）为因变量，采用逻辑回归分析的比值比（95%置信区间）进行数据提取。
伴有焦虑和/或抑郁的患者呼吸困难改善的可能性较小。骨质疏松症与功能锻炼能力改善较少相关，而心血管疾病似乎对这一结果没有负面影响。患有心血管合并症的患者生活质量的积极变化较少。
文献证据表明，合并症可能对肺康复效果产生负面影响。在肺康复环境中筛查合并症似乎有助于为适合的患者重新制定个性化的肺康复方案。
