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间质性肺疾病的严重程度是否会影响肺康复的效果?

Does the severity of interstitial lung disease affect the gains from pulmonary rehabilitation?

作者信息

Deniz Sami, Şahin Hülya, Yalnız Enver

机构信息

Department of Chest Diseases, Sağlık Bilimleri University, İzmir Dr Suat Seren Chest Diseases and Thoracic Surgery Research and Educational Hospital, İzmir, Turkey.

出版信息

Clin Respir J. 2018 Jun;12(6):2141-2150. doi: 10.1111/crj.12785. Epub 2018 Mar 24.

Abstract

INTRODUCTION

Reduced exercise capacity is a main feature of Interstitial Lung Diseases (ILDs) and it is related to closely prognosis of these patients. Pulmonary Rehabilitation (PR) results to improve in peak exercise capacity, dyspnea and quality of life in ILDs.

OBJECTIVES

We aimed to evaluate the benefits of PR in patients with ILDs and to determine whether there are similar gains in patients with severe ILD.

METHODS

We recruited ILD stable patients. All patients were evaluated with pulmonary function test, exercise capacity [6-minute walking test (6MWD)], quality of life [Short Form-36 (SF-36), St. George's Respiratory Questionnare (SGRQ), Hospital anxiety and Depression (HAD)] before and after PR (8 week).

RESULTS

Fifty-seven patients who completed PR program, 30 women and 27 men, included in this study. It was determined a significant difference in terms of quality of life and exercise capacity (P < .05) before and after PR. When these patients were divided into 2 groups (DLCO <40% predicted, severe: group-1, and group-2: other ≥40], there was no difference between 2 groups except for forced expiratory volume in 1 second, pulse oxygen saturation and partial oxygen pressure (pO ). When compared the differences between pre and post values of all variables, there was no difference significantly except 4 variables (SF-36; physical functioning, social functioning, role physical and pO ).

CONCLUSION

PR led to improvement in quality of life and exercise capacity in ILDs. In addition, PR, irrespective of the severity of the disease, is particularly beneficial in patients with severe ILDs.

摘要

引言

运动能力下降是间质性肺疾病(ILDs)的主要特征,且与这些患者的预后密切相关。肺康复(PR)可改善ILDs患者的峰值运动能力、呼吸困难及生活质量。

目的

我们旨在评估PR对ILDs患者的益处,并确定重度ILDs患者是否有类似的改善。

方法

我们招募了病情稳定的ILDs患者。所有患者在PR(8周)前后均接受了肺功能测试、运动能力[6分钟步行试验(6MWD)]、生活质量[简明健康调查问卷(SF-36)、圣乔治呼吸问卷(SGRQ)、医院焦虑抑郁量表(HAD)]评估。

结果

本研究纳入了57名完成PR项目的患者,其中30名女性和27名男性。结果显示,PR前后患者的生活质量和运动能力存在显著差异(P < 0.05)。当将这些患者分为两组(预计一氧化碳弥散量<40%,重度:第1组;第2组:其他≥40%)时,除1秒用力呼气量、脉搏血氧饱和度和氧分压(pO)外,两组之间没有差异。比较所有变量的前后值差异时,除4个变量(SF-36;身体功能、社会功能、角色身体功能和pO)外,没有显著差异。

结论

PR可改善ILDs患者的生活质量和运动能力。此外,无论疾病严重程度如何,PR对重度ILDs患者尤其有益。

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