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心肺康复对肺动脉高压的影响:一项前瞻性随机研究。

Effects of cardiopulmonary rehabilitation on pulmonary arterial hypertension: A prospective, randomized study.

作者信息

Karapolat Hale, Çınar Müyesser Ece, Tanıgör Göksel, Nalbantgil Sanem, Kayıkçıoğlu Meral, Moğulkoç Nesrin, Kültürsay Hakan

机构信息

Department of Physical Medicine and Rehabilitation, Ege Üniversitesi School of Medicine, Izmir, Turkey.

Department of Cardiology, Ege Üniversitesi School of Medicine, Izmir, Turkey.

出版信息

Turk J Phys Med Rehabil. 2019 May 8;65(3):278-286. doi: 10.5606/tftrd.2019.2758. eCollection 2019 Sep.

Abstract

OBJECTIVES

This study aims to investigate the effects of cardiopulmonary rehabilitation (CPR) on cardiopulmonary function, quality of life, depression, and hemodynamic parameters in patients with pulmonary arterial hypertension (PAH) and to compare the efficacy of hospital- and home-based exercise programs.

PATIENTS AND METHODS

Between December 2014 to May 2016, a total of 30 patients with PAH were included in the study. The patients were randomly assigned to either a hospital-based (n=15) or home-based exercise program (n=15). The hospital group was assigned to a cardiac rehabilitation (three days/week, 1 hour/week 50 to 70% maximal oxygen uptake [PvO]) program for eight weeks. The home-based exercise group received home exercises alone. Before and after eight weeks of rehabilitation, all patients were evaluated for their functional status (PvO), pulmonary function including forced expiratory volume in one sec (FEV1), mL, forced vital capacity (FVC), mL and FEV1/FVC%, quality of life using Short Form-36 (SF-36), depression severity using Beck Depression Inventory, and hemodynamic parameters including left ventricular ejection fraction, right ventricular ejection fraction, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and systolic pulmonary arterial pressure.

RESULTS

Of the patients, 12 completed the study in each group. There was no statistically significant difference in the functional status, quality of life, depression severity, and hemodynamic parameters after the rehabilitation compared baseline between the groups.

CONCLUSION

Based on our study results, short-term CPR seems not to be beneficial in patients with PAH. We recommend long-term rehabilitation programs to achieve more benefits from aerobic exercise training in this patient population.

摘要

目的

本研究旨在探讨心肺康复(CPR)对肺动脉高压(PAH)患者心肺功能、生活质量、抑郁及血流动力学参数的影响,并比较医院和家庭运动方案的疗效。

患者与方法

2014年12月至2016年5月期间,共有30例PAH患者纳入本研究。患者被随机分为医院运动方案组(n = 15)或家庭运动方案组(n = 15)。医院组接受心脏康复(每周三天,每周1小时,最大摄氧量[PvO]的50%至70%)方案,为期八周。家庭运动组仅接受家庭锻炼。在康复八周前后,对所有患者进行功能状态(PvO)、肺功能评估,包括一秒用力呼气量(FEV1,mL)、用力肺活量(FVC,mL)和FEV1/FVC%,使用简短健康调查问卷(SF-36)评估生活质量,使用贝克抑郁量表评估抑郁严重程度,以及血流动力学参数评估,包括左心室射血分数(LVEF)、右心室射血分数(RVEF)、左心室收缩末期内径、左心室舒张末期内径和收缩期肺动脉压。

结果

每组各有12例患者完成研究。康复后,两组之间在功能状态、生活质量、抑郁严重程度和血流动力学参数方面与基线相比无统计学显著差异。

结论

基于我们的研究结果,短期心肺康复对PAH患者似乎并无益处。我们建议采用长期康复方案,以便在该患者群体中从有氧运动训练中获得更多益处。

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