Charikiopoulou Maria, Nikolaidis Pantelis Theodoros, Knechtle Beat, Rosemann Thomas, Rapti Aggeliki, Trakada Georgia
Pulmonary Rehabilitation Department, General Hospital for Chest Diseases of Athens "SOTIRIA", Athens, Greece.
2nd Pulmonary Department, General Hospital for Chest Diseases of Athens "SOTIRIA", Athens, Greece.
Front Physiol. 2019 Mar 22;10:286. doi: 10.3389/fphys.2019.00286. eCollection 2019.
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with multiple systemic manifestations and comorbidities, which contribute independently to its total morbidity and mortality. Pulmonary rehabilitation is an evidence-based intervention that is indicated for COPD patients who remain symptomatic, despite optimal pharmacological therapy. Although it is well documented in pure COPD, the role of pulmonary rehabilitation is uncertain in coexisting comorbidities. The aim of the present study was to clarify the effect of a pulmonary rehabilitation program in COPD patients with concomitant comorbidities. Thirty two patients with COPD were evaluated before and after a comprehensive pulmonary rehabilitation program, in terms of dyspnea, quality of life (QOL), pulmonary function tests and exercise capacity. The patients were also divided into two groups, according to the presence or the absence of comorbidities. Patients with none or only one comorbidity (Group 1, = 11) were compared to those who had two or more comorbidities (Group 2, = 21). All patients significantly improved in dyspnea, as expressed by modified Medical Research Council scale and the COPD assessment Test ( < 0.001), QOL as assessed by the St. George respiratory questionnaire ( < 0.001) and exercise tolerance in six minute walking test ( < 0.001). Peak oxygen uptake relatively increased and body mass decreased in Group 1 compared to Group 2 ( < 0.05). Pulmonary rehabilitation in COPD seems to be beneficial for all patients, independently of the presence, the number or the nature of their comorbidities. Thus, the presence of comorbidities must not represent an exclusion criterion for patients that are referred to pulmonary rehabilitation programs. Current controlled trials ISRCTN14648515 Retrospectively registered 15 February 2018.
慢性阻塞性肺疾病（COPD）是一种具有多种全身表现和合并症的异质性疾病，这些表现和合并症各自独立地导致其总体发病率和死亡率。肺康复是一种基于证据的干预措施，适用于尽管接受了最佳药物治疗仍有症状的COPD患者。虽然在单纯COPD中已有充分记录，但肺康复在并存合并症中的作用尚不确定。本研究的目的是阐明肺康复计划对合并合并症的COPD患者的影响。对32例COPD患者在综合肺康复计划前后进行了呼吸困难、生活质量（QOL）、肺功能测试和运动能力方面的评估。患者还根据是否存在合并症分为两组。将无合并症或仅有1种合并症的患者（第1组，n = 11）与有2种或更多合并症的患者（第2组，n = 21）进行比较。所有患者的呼吸困难均有显著改善，采用改良医学研究委员会量表和慢性阻塞性肺疾病评估测试表示（P < 0.001），生活质量采用圣乔治呼吸问卷评估（P < 0.001），六分钟步行试验中的运动耐量（P < 0.001）。与第2组相比，第1组的峰值摄氧量相对增加，体重下降（P < 0.05）。COPD患者的肺康复似乎对所有患者都有益，无论其合并症的存在、数量或性质如何。因此，合并症的存在不应成为转诊至肺康复计划患者的排除标准。当前对照试验ISRCTN14648515于2018年2月15日进行回顾性注册。
