Ichikawa Masako, Kodama Yuzo, Yoshimi Kaku, Shiota Satomi, Kotajima Masaki, Nakajyo Mami, Seyama Kuniaki, Fukuchi Yoshinosuke, Takahashi Kazuhisa
1 Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan ; 2 Medical engineering, Juntendo University Hospital, Tokyo, Japan.
J Thorac Dis. 2015 Apr;7(4):687-96. doi: 10.3978/j.issn.2072-1439.2015.04.22.
Poor exercise tolerability is a major barrier to improving the quality of life of patients with chronic obstructive pulmonary disease (COPD). Although COPD is often treated with long-acting β2 adrenergic agonists, few studies have examined their effects on exercise tolerability.
In this study, Japanese COPD patients were treated with 2 mg transdermal tulobuterol, a long-acting β2 agonist, once daily for 4 weeks. Spirometry and exercise tests were conducted at baseline and at the end of treatment. The patients conducted constant load (30 W for 5 min) and incremental load (starting at 10 W and increasing by 10 W every 1 min for 5 min to a maximum load of 50 W) exercise tests on a cycle ergometer.
Thirteen patients with stable COPD participated in this study (mean age ± standard deviation (SD), 69.5±9.7 years; smoking history 55.9±27.8 pack-years). Resting spirometric parameters were unchanged at the end of treatment. The maximum Borg scale for dyspnea and the Borg scale slope (BSS) decreased significantly from baseline to the end of treatment. The threshold load of dyspnea (TLD) increased slightly, although not significantly, in the constant load test but not in the incremental load test. There were no changes in respiratory parameters during exercise after treatment.
In conclusion, we found that treatment with transdermal tulobuterol for 4 weeks improved self-assessed dyspnea in Japanese COPD patients during constant and incremental exercise tests. This improvement in dyspnea may encourage patients to perform daily life activities or regular physical activity.
运动耐量差是改善慢性阻塞性肺疾病(COPD)患者生活质量的主要障碍。尽管COPD通常使用长效β2肾上腺素能激动剂进行治疗,但很少有研究考察其对运动耐量的影响。
在本研究中,日本COPD患者接受2mg透皮妥洛特罗(一种长效β2激动剂)治疗,每日一次,共4周。在基线和治疗结束时进行肺功能测定和运动测试。患者在自行车测力计上进行恒定负荷(30W,持续5分钟)和递增负荷(从10W开始,每分钟增加10W,持续5分钟,最大负荷为50W)运动测试。
13例稳定期COPD患者参与了本研究(平均年龄±标准差(SD),69.5±9.7岁;吸烟史55.9±27.8包年)。治疗结束时静息肺功能参数未改变。从基线到治疗结束,呼吸困难的最大Borg量表评分和Borg量表斜率(BSS)显著降低。在恒定负荷测试中,呼吸困难阈值负荷(TLD)略有增加,虽不显著,但在递增负荷测试中未增加。治疗后运动期间呼吸参数无变化。
总之,我们发现透皮妥洛特罗治疗4周可改善日本COPD患者在恒定和递增运动测试期间自我评估的呼吸困难。呼吸困难的这种改善可能会鼓励患者进行日常生活活动或定期体育锻炼。