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孙 丽,黄惠雪,白 雪,纪 红.肺康复对老年慢性阻塞性肺疾病稳定期患者血清炎症因子的影响[J].中国康复医学杂志,2016,(4):434~438
肺康复对老年慢性阻塞性肺疾病稳定期患者血清炎症因子的影响    点此下载全文
孙 丽  黄惠雪  白 雪  纪 红
辽宁医学院航天中心医院研究生培养基地,北京海淀区玉泉路15号,100049
基金项目:北京市海淀区科技项目(K2012011S)
DOI:
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摘要:
      摘要 目的:研究肺康复对老年慢性阻塞性肺疾病(COPD)稳定期患者临床症状改善与血清炎症因子的变化。 方法:前瞻性地收集老年COPD稳定期患者,分为肺康复组和对照组,肺康复组进行12周的肺康复训练,对照组采用常规内科用药,2组分别于治疗前后测定肺功能、6分钟步行试验(6MWT)、COPD患者自我评估测试(CAT)以及血清C-反应蛋白(CRP),纤维蛋白原(Fbg),白细胞介素-6(IL-6)和肿瘤坏死因子(TNF-ɑ)水平,并进行组内比较。 结果:共纳入老年COPD患者51例,分为2组,肺康复组26例,对照组25例。治疗12周后,与治疗前比较,肺康复组患者的6MWT增加、CAT降低(P<0.05),肺功能的FEV1%、FEV1/FVC较治疗前明显增加(P<0.01);治疗后肺康复组的血清CRP、TNF-ɑ水平均比治疗前下降(P<0.05),而肺康复组的IL-6、Fbg无明显变化(P>0.05)。对照组治疗前后肺功能、6MWT、CAT及血炎症因子均有变化,但无显著性差异(P>0.05)。 结论:老年COPD稳定期患者通过肺康复治疗可以缓解呼吸困难症状,提高活动能力和耐力,延缓肺功能损害的进展;也可以降低部分血炎症因子的水平,有利于延缓COPD的进展。
关键词:慢性阻塞性肺疾病  肺康复  肺功能  血清炎症因子
Effect of pulmonary rehabilitation on inflammatory factors in serum of senile patients with stable chronic obstructive pulmonary disease    Download Fulltext
Postgraduate Education Base of Space Center Hospital, Liaoning Medical University,Beijing,100049
Fund Project:
Abstract:
      Abstract Objective: To investigate the effects of pulmonary rehabilitation (PR) on symptom improvements and levels of serum inflammatory factors in senile patients with stable chronic obstructive pulmonary disease (COPD). Method: Senile patients with stable COPD were included in a prospective, single center study. They were randomized into two groups, the control group were treated with regular therapy, while the intervention group were treated with both regular one and PR for 12 weeks. Pulmonary function, six-minute walk test (6MWT) and COPD assessment test (CAT), level of serum c-reactive protein(CRP), fibrinogen(Fbg), interleukin-6(IL-6), and tumornecrosis factor-α(TNF-α) before and after treatment were compared between the two groups. Result: Fifty-one patients with stable COPD were included into this study, 25 patients were allocated to the control group and 26 to the intervention group. Compared to the baseline before treatment, 6MWT, FEV1% and FVC improved significantly (P<0.01), and CAT decreased (P<0.05) in intervention group. The serum level of CRP and TNF-ɑ decreased significantly after treatment in intervention group (P<0.05). No statistical improvement revealed in IL-6, Fbg measurement in intervention group after PR. Patients in control group revealed no statistical significant improvement(P>0.05) in pulmonary function, 6MWT, CAT, and level of inflammatory factors after treatment. Conclusion: In stable senile patients with COPD patients, PR has beneficial effects on pulmonary function by relieving dyspnea symptoms, improving activities of daily live, and slowing impairments on pulmonary functions. PR also showed beneficial effects on lowering inflammatory factor levels in the progress of COPD.
Keywords:chronic obstructive pulmonary disease  pulmonary rehabilitation  pulmonary function  inflammatory factors in scrum
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