[1]丁洁,向文海,王启星,等.基于Spiro-tiger训练仪的肺康复对COPD稳定期患者呼吸力学、气道重塑的影响[J].中国医学物理学杂志,2023,40(12):1558-1563.[doi:DOI:10.3969/j.issn.1005-202X.2023.12.016]
　DING Jie,XIANG Wenhai,WANG Qixing,et al.Effects of lung rehabilitation based on Spiro-tiger training apparatus on respiratory mechanics and airway remodeling in stable COPD patients[J].Chinese Journal of Medical Physics,2023,40(12):1558-1563.[doi:DOI:10.3969/j.issn.1005-202X.2023.12.016]
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基于Spiro-tiger训练仪的肺康复对COPD稳定期患者呼吸力学、气道重塑的影响()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
40卷
期数:
2023年第12期
页码:
1558-1563
栏目:
医学生物物理
出版日期:
2023-12-27

文章信息/Info

Title:
Effects of lung rehabilitation based on Spiro-tiger training apparatus on respiratory mechanics and airway remodeling in stable COPD patients
文章编号:
1005-202X（2023）12-1558-06
作者:
丁洁1; 向文海1; 王启星2; 龚秀玲1; 杨扬1; 王桂丽1; 肖伟1
1.上海瑞金医院南翔分院康复医学科， 上海 201802； 2.同济大学附属第十人民医院重症医学科， 上海 200072
Author(s):
DING Jie1;  XIANG Wenhai1;  WANG Qixing2;  GONG Xiuling1;  YANG Yang1;  WANG Guili1;  XIAO Wei1
1. Department of Rehabilitation Medicine, Nanxiang Branch of Shanghai Ruijin Hospital, Shanghai 201802, China 2. Intensive Care Unit, Tenth Peoples Hospital of Tongji University, Shanghai 200072, China
关键词:
慢性阻塞性肺疾病; Spiro-tiger训练仪; 呼吸力学; 气道重塑
Keywords:
Keywords: chronic obstructive pulmonary disease Spiro-tiger training apparatus respiratory mechanics airway remodeling
分类号:
R318.6；R563
DOI:
DOI:10.3969/j.issn.1005-202X.2023.12.016
文献标志码:
A
摘要:
目的：探讨慢性阻塞性肺疾病（COPD）稳定期患者采用基于Spiro-tiger训练仪的肺康复对呼吸力学、气道重塑的影响。方法：选取在上海瑞金医院南翔分院就诊的93例COPD稳定期患者，通过随机数表法分为对照组（46例）与观察组（47例）进行研究，对照组采用缩唇-腹式呼吸操干预，观察组在对照组基础上采用Spiro-tiger训练仪干预，两组均连续干预9周，对比两组干预前、干预9周后呼吸力学（呼吸频率、潮气量、每分通气量、呼吸道压力峰值）、气道重塑［基质金属蛋白酶-9（MMP-9）、血管内皮生长因子（VEGF）、转化生长因子（TGF-[β]1）］、肺功能［用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC］、血气指标［动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）］、6 min步行距离、健康状况［Borg分级及圣乔治呼吸问卷（SGRQ）评分］，并随访6个月，统计COPD急性加重发生状况。结果：干预9周，相较于对照组，观察组的呼吸频率、呼吸道压力峰值低，潮气量高（P<0.05）；两组每分通气量比较差异无统计学意义（P>0.05）；相较于对照组，观察组的MMP-9、VEGF、TGF-β1、PaCO2水平低，FVC、FEV1、FEV1/FVC、PaO2水平高（P<0.05）；相较于对照组，观察组的6 min步行距离长，Borg分级评分、SGRQ评分低于干预前，且观察组变化幅度大于对照组（P<0.05）；随访6个月，观察组COPD急性加重发生率（4.26%）低于对照组（19.57%）（P<0.05）。结论：基于Spiro-tiger训练仪的肺康复可有效改善COPD稳定期患者呼吸力学、肺功能、血气指标及健康状况，减轻气道重塑，减少COPD急性加重。
Abstract:
Abstract: Objective To explore the effects of lung rehabilitation using Spiro-tiger training apparatus on the respiratory mechanics and airway remodeling in patients with chronic obstructive pulmonary disease (COPD) in stable stage. Methods Ninety-three stable COPD patients admitted to Nanxiang Branch of Shanghai Ruijin Hospital were randomly divided into control group (46 cases) and observation group (47 cases). Control group was treated with the training for pursed lips breathing and abdominal breathing, and observation group was trained with Spiro-tiger training apparatus in addition to the treatment given to control group. Both groups were intervened continuously for 9 weeks. The two groups were compared in terms of respiratory mechanics (respiratory frequency, tidal volume, minute ventilation, and peak respiratory pressure), airway remodeling ［matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor (VEGF), and transforming growth factor-β1 (TGF-β1)］, and lung function ［forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC］, blood gas analysis indexes ［arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2)］, 6-minute walking distance (6MWD) and health status ［Borg scale and St. Georges respiratory questionnaire (SGRQ)］. The patients were followed up for 6 months, and the incidence of acute exacerbation of COPD was recorded. Results After 9 weeks of intervention, compared with control group, observation group had lower peak respiratory frequency and respiratory pressure, and higher tidal volume (P<0.05). There was no significant difference in minute ventilation between two groups (P>0.05). The levels of MMP-9, VEGF, TGF-β1 and PaCO2 were lower, and FVC, FEV1, FEV1/FVC and PaO2 were higher in observation group than in control group (P<0.05). Observation group had longer 6MWD, and lower Borg score and SGRQ score as compared with control group (P<0.05). After 6-month follow-up, the incidence of COPD acute exacerbation in observation group was lower than that in control group (4.26% vs 19.57%, P<0.05). Conclusion Lung rehabilitation using Spiro-tiger training apparatus can effectively improve respiratory mechanics, lung function, blood gas analysis indexes and health status in stable COPD patients, alleviate airway remodeling, and avoid acute exacerbation of COPD.

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备注/Memo

备注/Memo:
【收稿日期】2023-06-11 【基金项目】上海市科委项目（16401970400）；上海市嘉定区自然科学研究项目（JDKW-2020-0026） 【作者简介】丁洁，硕士，主治医师，研究方向：心肺康复，E-mail: djluck890@126.com 【通信作者】向文海，副主任医师，研究方向：康复医学，E-mail: xwh75@163.com
更新日期/Last Update: 2023-12-27