物理治疗对不同严重程度肺部疾病的囊性纤维化患者通气不均匀性的短期影响。
Short-term effects of physiotherapy on ventilation inhomogeneity in cystic fibrosis patients with a wide range of lung disease severity.
作者信息
Pfleger A, Steinbacher M, Schwantzer G, Weinhandl E, Wagner M, Eber E
机构信息
Respiratory and Allergic Disease Division, Department of Paediatrics and Adolescent Medicine, Medical University of Graz Austria.
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz Austria.
出版信息
J Cyst Fibros. 2015 Sep;14(5):627-31. doi: 10.1016/j.jcf.2014.12.017. Epub 2015 Jan 19.
BACKGROUND
Lung clearance index (LCI) is increasingly used as a study endpoint for therapeutic interventions in cystic fibrosis (CF) patients. We set out to assess the effect of chest physiotherapy on ventilation inhomogeneity in clinically stable patients with CF lung disease of varying severity.
METHODS
In 29 CF patients (7.3-43.7 years) N2MBW (nitrogen multiple breath washout), plethysmography, and spirometry measurements were conducted, followed by 30 min of supervised PEP mask chest physiotherapy and repeated measurements 30 min after therapy.
RESULTS
We observed a mean change in LCI after physiotherapy from 15.00 to 14.80 (range, -4.84 to 3.37; p=0.578). In seven patients, LCI decreased, and in ten patients, LCI increased by ≥1. For the whole group, statistically significant improvements were seen in Reff, FEV1, FVC, and MEF50.
CONCLUSIONS
By opening up previously poorly ventilated lung regions, physiotherapy may either increase or decrease ventilation inhomogeneity; the short-term effect of physiotherapy on LCI appears to be unpredictable.
背景
肺清除指数（LCI）越来越多地被用作囊性纤维化（CF）患者治疗干预的研究终点。我们旨在评估胸部物理治疗对不同严重程度的临床稳定CF肺病患者通气不均匀性的影响。
方法
对29例CF患者（7.3 - 43.7岁）进行了氮多次呼吸冲洗（N2MBW）、体积描记法和肺活量测定，随后进行30分钟的监督下PEP面罩胸部物理治疗，并在治疗后30分钟重复测量。
结果
我们观察到物理治疗后LCI的平均变化从15.00降至14.80（范围为 - 4.84至3.37；p = 0.578）。7例患者LCI降低，10例患者LCI升高≥1。对于整个组，在有效率（Reff）、第一秒用力呼气容积（FEV1）、用力肺活量（FVC）和50%最大呼气流量（MEF50）方面观察到有统计学意义的改善。
结论
通过打开先前通气不良的肺区域，物理治疗可能会增加或减少通气不均匀性；物理治疗对LCI的短期影响似乎是不可预测的。
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