Spielmanns M, Gloeckl R, Schmoor C, Windisch W, Storre J H, Boensch M, Kenn K
Remigius Hospital, Leverkusen, Opladen, Germany; Department of Pneumology, University of Witten/Herdecke, Germany.
Department of Respiratory Medicine & Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department of Prevention, Rehabilitation and Sports Medicine, Klinikum Rechts der Isar, Technische Universität München (TUM), Munich, Germany.
Respir Med. 2016 Apr;113:8-14. doi: 10.1016/j.rmed.2016.02.006. Epub 2016 Feb 17.
The response of patients in a pulmonary rehabilitation (PR) is essentially good. However, not all patients benefit from PR to the same extent. In this analysis we wanted to identify the impact of gender and other factors on PR outcomes in patients with chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD).
Patients suffering from COPD (n = 1492) or ILD (n = 599), treated during an inpatient PR between 1997 and 2015, were analysed according to the effects of PR on exercise capacity and quality of life with regard to the impact of gender or other predictors by univariate and multivariate analyzes.
In the group of COPD patients, 30% did not achieve the expected physical performance during the 6-min walk test (28% of female and 32% of male patients). However, the non-responders initially have had a higher 6-min walking distance (6-MWD) (p < 0.001) and both male and female showed a significant lower BODE index (p = 0.025) in the multivariate analysis. In the ILD-group, 37% females and 43% males were classified as non-responders with regard to the 6-MWD. Also in this group, the non-responders initially have had a higher 6-MWD (p < 0.001). All other variables (age, BMI, lung function, blood gases, C-reactive Protein, Haemoglobin or rehabilitation duration) had no influence on the outcome.
Our study supports the positive effects of PR in COPD and ILD patients. In both groups, patients with the biggest limitations benefit most from PR. However, relevant gender differences or other predictors could not be found.
肺部康复（PR）患者的反应总体良好。然而，并非所有患者都能从PR中获得同等程度的益处。在本分析中，我们旨在确定性别和其他因素对慢性阻塞性肺疾病（COPD）或间质性肺疾病（ILD）患者PR结局的影响。
对1997年至2015年期间住院接受PR治疗的COPD患者（n = 1492）或ILD患者（n = 599），通过单因素和多因素分析，根据PR对运动能力和生活质量的影响，分析性别或其他预测因素的作用。
在COPD患者组中，30%的患者在6分钟步行试验中未达到预期的身体表现（女性患者为28%，男性患者为32%）。然而，在多因素分析中，无反应者最初的6分钟步行距离（6-MWD）较高（p < 0.001）。男性和女性的BODE指数均显著较低（p = 0.025）。在ILD组中，就6-MWD而言，37%的女性和43%的男性被归类为无反应者。同样在该组中，无反应者最初的6-MWD较高（p < 0.001）。所有其他变量（年龄、体重指数、肺功能、血气、C反应蛋白、血红蛋白或康复持续时间）对结局均无影响。
我们的研究支持PR对COPD和ILD患者的积极作用。在两组中，受限最大的患者从PR中获益最多。然而，未发现相关的性别差异或其他预测因素。
