低强度心肺运动试验对慢性阻塞性肺疾病患者康复训练的试验研究

Experimental study of persistent low-intensity cardiopulmonary exercise test on pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

目的探讨稳定期COPD患者采用低强度持续性踏车式心肺运动试验（CPET）训练的价值。方法选稳定期COPD患者57例，随机分成对照组26例和康复组31例，对照组给予常规治疗及健康宣教，康复组在此基础上进行12周低强度（运动强度为无氧阈时的功率）的踏车式CPET。2组患者在运动前后测定血清IL-8、肿瘤坏死因子α（TNF-α）、丙二醛（MDA）、超氧化物歧化酶（SOD）、6分钟步行距离、COPD评估测试量表（CAT）。结果经过12周的运动训练，康复组患者血清IL-8、TNF—α、MDA水平较治疗前均有降低，SOD水平较前增加，且运动后均明显优于对照组，差异有统计学意义（P〈0．05）；2组患者6分钟步行距离明显增加，CAT评分显著降低，上述指标康复组均明显优于对照组，差异有统计学意义（P〈0．05）。结论低强度持续CPET能够改善COPD炎症反应、氧化应激及生活质量，适用于稳定期COPD患者康复治疗。

Objective To explore the clinical value of persistent low-intensity cycle ergometer training in patients with stable chronic obstructive pulmonary disease （COPD）. Methods Fifty seven patients with stable COPD were randomly divided into a control （26 cases）,a treatment （31 cases）. All patients received conventional medical therapy and health education, meanwhile patients of treatment group added low-intensity （exercise intensity level measured by anaerobic threshold） cycle ergometer training,which was for a period of 12 weeks, 3-5 times per week, each 30 minutes. Serum IL 8, TNF-α, MDA,SOD levels and 6-minute walking distance,CAT were detected both before and after the training. Results At 12 weeks,the serum IL-8,TNF-α,MDA levels were decreased and the serum SOD level was improved in the treatment group, which was better than the control group, the difference was of statistical significance （P 〈 0.05）. 6-minute walking distance was significantly increased, CAT scores were significantly reduced in the two groups, and these indictors in the treatment group were better than the control group, the difference was of statistical significance （ P 〈 0.05）. Conclusions Persistent low- intensity CPET improving the inflammatory response, oxidative stress and quality of life, which is suitable for patients with stable COPD.