Kaymaz Dicle, Ergün Pınar, Candemir Ipek, Utku Ezgi, Demir Neşe, Şengül Fatma, Egesel Nurcan, Demir Pervin
Ankara Ataturk Chest Diseases and Chest Surgery Training and Research Hospital, Pulmonary Rehabilitation and Home Care Center, Ankara, Turkey.
Tuberk Toraks. 2013;61(4):295-302. doi: 10.5578/tt.6291.
Interstitial lung diseases are characterised by dyspnea on exertion, low quality of life, cough and exercise intolerance. The aim of this study was to evaluate the effects of comprehensive pulmonary rehabilitation in patients with interstitial lung disease.
Data from patients who were referred to pulmonary rehabilitation with the diagnosis of interstitial lung diseases were included to this study. Ten patients with interstitial lung disease participated to our outpatient, 8 weeks, comprehensive pulmonary rehabilitation programme. Dyspnea was assessed with the Medical Research Council (MRC) scale; health related quality of life was assessed with the St.George's Respiratory Questionnaire (SGRQ). Exercise capacity was measured using the incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT); anxiety and depression were assessed with the hospital anxiety depression scale (HADS). All parameters were recorded before and after pulmonary rehabilitation programme.
Dyspnea sensation, anxiety and depression scores decreased after pulmonary rehabilitation (p: 0.023, p: 0.026, p: 0.039 respectively). Also impact domains of SGRQ significantly reduced (Z= 1.988; p= 0.047).The difference between median values of ISWT results before and after pulmonary rehabilitation was 60 meters. Although it was not statistically significant (Z= 1.863; p= 0.063), the level of increment was higher than the minimaly important clinical differance for ISWT.
Our results showed that comprehensive pulmonary rehabilitation programmes were benefical for patients with interstitial lung diseases and it should be regarded as a standard care in this population from the early stages.
间质性肺疾病的特征为劳力性呼吸困难、生活质量低下、咳嗽和运动不耐受。本研究的目的是评估综合肺康复对间质性肺疾病患者的影响。
本研究纳入了被诊断为间质性肺疾病并转诊至肺康复科的患者数据。10例间质性肺疾病患者参加了我们为期8周的门诊综合肺康复计划。采用医学研究委员会（MRC）量表评估呼吸困难；采用圣乔治呼吸问卷（SGRQ）评估健康相关生活质量。使用递增往返步行试验（ISWT）和耐力往返步行试验（ESWT）测量运动能力；采用医院焦虑抑郁量表（HADS）评估焦虑和抑郁。在肺康复计划前后记录所有参数。
肺康复后呼吸困难感觉、焦虑和抑郁评分降低（p值分别为0.023、0.026、0.039）。SGRQ的影响领域也显著降低（Z = 1.988；p = 0.047）。肺康复前后ISWT结果中位数的差异为60米。虽然差异无统计学意义（Z = 1.863；p = 0.063），但增加水平高于ISWT的最小重要临床差异。
我们的结果表明，综合肺康复计划对间质性肺疾病患者有益，应从早期阶段就将其视为该人群的标准治疗方法。
