临床治疗对慢性阻塞性肺疾病患者执行功能的影响

Effect of clinical treatment on executive function in patients with chronic obstructive pulmonary disease

目的探讨临床治疗对慢性阻塞性肺疾病(Chronic obstructive pulmonary disease)患者执行功能的影响。方法对50例慢阻肺患者及与其相匹配的50名健康对照被试(health controls,HC)通过字母符号替换测试(Letter Digit Substitution Test,LDST)、连线测试(Trall Making Test,TMT)、Go-Nogo测试比较认知功能,并比较慢阻肺组治疗前后执行功能差异。结果治疗前慢阻肺组在LDST、TMT-A、TMT-B、GO/Nogo测试的错误数和反应时方面差于HC组,差异有统计学意义[(39.18±6.72)分vs(44.78±7.65)分;(56.60±13.82)s vs(50.42±13.91)s;(116.50±29.29)s vs(95.44±20.32)s;(3.80±2.63)次vs(3.26±2.34)次;(1580.20±332.17)ms vs(839.09±231.60)ms](分别为:t=-3.890,P<0.001;t=2.229,P=0.028;t=4.177,P<0.001;t=1.086,P=0.280;t=12.941,P<0.001);治疗后慢阻肺组在LDST、TMT-A、TMT-B、GO/Nogo测试的错误数和反应时方面均差于HC组,差异均有统计学意义[(42.32±6.97)分vs(43.98±7.06)分;(52.66±14.40)s vs(47.72±9.44)s;(95.54±23.32)s vs(88.92±19.56)s;(2.78±1.56)次vs(2.68±1.50)次;(1461.65±283.86)ms vs(796.53±154.02)ms](分别为:t=-1.169,P=0.245;t=2.209,P=0.045;t=1.538,P=0.127;t=0.327,P=0.745;t=14.563,P<0.001);慢阻肺组治疗后在LDST、TMT-B、GO/Nogo测试的错误数和反应时方面均有较大改善,差异均有统计学意义(分别为:t=2.428,P=0.019;t=2.238,P=0.030;t=-2.435,P=0.019;t=4.914,P<0.001)。HC组2次测试差异并无统计学意义。结论慢阻肺患者存在执行功能损伤,临床治疗能够提高慢阻肺患者执行功能。

Objective To investigate the effect of clinical treatment on executive function in patients with chronic obstructive pulmonary disease. Methods A total of 50 patients with chronic obstructive pulmonary disease were compared with 50 healthy controls on executive function by letter digit substitution test( LDST),trall making test( TMT),and Go-Nogo test between the two groups. Before and after the intervention,the difference of executive function was compared between the two groups. Results The perform of LDST,TMT-A,TMT-B,wrong number and reaction time of Go-Nogo test in the COPD patients was worse than that of the HC group before clinical treatment[( 39. 18 ± 6. 72) score vs( 44. 78 ± 7. 65) score;( 56. 60 ± 13. 82) s vs( 50. 42 ± 13. 91) s;( 116. 50 ± 29. 29) s vs( 95. 44 ± 20. 32) s;( 3. 80 ± 2. 63) time vs( 3. 26 ± 2. 34) time;( 1580. 20 ± 332. 17) ms vs( 839. 09 ± 231. 60) ms]( t =-3. 890,P < 0. 001; t = 2. 229,P = 0. 028; t = 4. 177,P < 0. 001; t = 1. 086,P = 0. 280; t = 12. 941,P <0. 001 respectively). The perform of LDST,TMT-A,TMT-B,wrong number and reaction time of Go-Nogo test in the COPD patients was worse than that of the HC group after clinical treatment( 42. 32 ± 6. 97) score vs( 43. 98 ± 7. 06)score;( 52. 66 ± 14. 40) s vs( 47. 72 ± 9. 44) s;( 95. 54 ± 23. 32) s vs( 88. 92 ± 19. 56) s;( 2. 78 ± 1. 56) time vs( 2. 68 ± 1. 50) time;( 1461. 65 ± 283. 86) ms vs( 796. 53 ± 154. 02) ms]( t =-1. 169,P = 0. 245; t = 2. 209,P= 0. 045; t = 1. 538,P = 0. 127; t = 0. 327,P = 0. 745; t = 14. 563,P < 0. 001 respectively). After treatment,the COPD group improved in the perform of LDST,TMT-B,wrong number and reaction time of Go-Nogo test( t = 2. 428,P = 0. 019; t = 2. 238,P = 0. 030; t =-2. 435,P = 0. 019; t = 4. 914,P < 0. 001 respectively). There was no statistically significant difference between the two tests in the HC group. Conclusion These results suggest that the patients with COPD have impairment in executive function,and the clinical treatment can improve executive function of COPD patients.