Ambrosino Nicolino, Venturelli Elena, de Blasio Francesco, Paggiaro Pierluigi, Pasqua Franco, Vitacca Michele, Vagheggini Guido, Clini Enrico M
Weaning and Rehabilitation Unit, Auxilium Vitae Rehabilitation Center, Volterra, Italy.
Respiration. 2015;89(2):141-7. doi: 10.1159/000371471. Epub 2015 Jan 28.
Recently, it has been proposed that different clinical phenotypes can be recognized in patients with chronic obstructive disease (COPD), namely predominant airway disease or parenchymal destructive changes.
The aim of this prospective multicenter study was to evaluate whether these two phenotypes may influence outcomes following a pulmonary rehabilitation program (PRP).
We have prospectively evaluated 364 consecutive COPD patients (70 ± 8 years, 76.3% males) admitted to a standard hospital-based PRP in 6 Italian centers. According to their phenotype, the study cohort was divided into two groups: patients with airway obstructive (group 1, n = 208) or parenchymal destructive COPD (group 2, n = 156). Before and after PRP, values of 6-min walking distance, perceived breathlessness (Medical Research Council), health-related quality of life (St. George's Respiratory Questionnaire) and respiratory muscle function (maximal inspiratory and expiratory pressure) were recorded.
PRP resulted in significant improvements in all outcome measures without any significant differences between groups.
Our study confirms that COPD patients may benefit from pulmonary rehabilitation independent of their clinical phenotype.
最近有人提出，在慢性阻塞性肺疾病（COPD）患者中可识别出不同的临床表型，即主要为气道疾病或实质破坏改变。
这项前瞻性多中心研究的目的是评估这两种表型是否会影响肺康复计划（PRP）后的结局。
我们前瞻性地评估了6家意大利中心收治的364例连续的COPD患者（70±8岁，76.3%为男性），这些患者均接受了基于医院的标准PRP。根据其表型，研究队列分为两组：气道阻塞性COPD患者（第1组，n = 208）或实质破坏性COPD患者（第2组，n = 156）。在PRP前后，记录6分钟步行距离、自觉呼吸困难程度（医学研究委员会分级）、健康相关生活质量（圣乔治呼吸问卷）和呼吸肌功能（最大吸气和呼气压力）的值。
PRP使所有结局指标均有显著改善，两组之间无任何显著差异。
我们的研究证实，COPD患者无论其临床表型如何，均可从肺康复中获益。
