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慢性阻塞性肺疾病急性加重后进行肺康复可降低再加重率

[Pulmonary Rehabilitation after Acute Exacerbation of COPD Reduces the Rate of Reexacerbations].

作者信息

Spielmanns Marc, Meier Andrea, Winkler Aurelia, Glöckl Rainer, Nell Christoph, Koczulla Andreas Rembert, Boeselt Tobias, Alter Peter, Magnet Friederike, Storre Jan Hendrik, Windisch Wolfram

机构信息

Abteilung Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Schön Klinik Berchtesgadener Land, Schönau am Königssee.

Philipps Universität Marburg, Klinik für Innere Medizin, Schwerpunkt Pneumologie und Intensivmedizin.

出版信息

Dtsch Med Wochenschr. 2017 Jan;142(2):e10-e19. doi: 10.1055/s-0042-121346. Epub 2017 Jan 23.

Abstract

Acute exacerbation of COPD (AECOPD) provides for patients a significant hazard and is crucial for the prognosis. Data on the effects of pulmonary rehabilitation (PR) on the frequency of reexacerbations after AECOPD are inconsistent. A prospective, case-control study was conducted with the aim of measuring the impact of PR on the frequency of reexacerbations after AECOPD.  A PR was performed in 57 patients with COPD after AECOPD. 30 participants were followed-up after one year and compared to 32 Control-Group (KG = hospitalized for AECOPD without PR). The rate of reexacerbations was both retrospectively in the year preceding the AECOPD, and prospectively in the year after AECOPD analyzed within groups and between groups.  In the intra group comparison the exacerbation rate was significantly lower in the PR-group in the year after rehabilitation (0.97 ± 2.67 vs. 1.52 ± 1.12; p < 0.001). The intergroup comparison also showed a significantly lower number of exacerbations for the PR-group (0.97 ± 1.52 vs 2.16 ± 1.25; p < 0.001).  It was shown that the exacerbation rate after an AECOPD could be significantly reduced in the PR-group in comparison to the KG-group during the investigation period of one year by PR. More prospective studies are required to define the value of PR in the context of AECOPD.

摘要

慢性阻塞性肺疾病急性加重(AECOPD)对患者构成重大危害,且对预后至关重要。关于肺康复(PR)对AECOPD后再发加重频率影响的数据并不一致。开展了一项前瞻性病例对照研究,旨在衡量PR对AECOPD后再发加重频率的影响。对57例AECOPD后的慢性阻塞性肺疾病患者进行了肺康复治疗。30名参与者在一年后进行随访,并与32名对照组(KG = 因AECOPD住院但未接受PR)进行比较。在AECOPD前一年回顾性分析再发加重率,并在AECOPD后一年前瞻性分析组内和组间的再发加重率。在组内比较中,康复后一年PR组的加重率显著更低(0.97±2.67对1.52±1.12;p < 0.001)。组间比较也显示PR组的加重次数显著更少(0.97±1.52对2.16±1.25;p < 0.001)。结果表明,在为期一年的调查期内,通过PR,PR组AECOPD后的加重率与KG组相比可显著降低。需要更多前瞻性研究来确定PR在AECOPD背景下的价值。

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