体外膈肌起搏对不同体质量指数慢性阻塞性肺疾病疗效比较

Therapeutic efficacy of external diaphragm pacing on chronic obstructive pulmonary disease patients with differ-ent body mass index

目的 :回顾性评价体外膈肌起搏(external diaphragm pacing, EDP)对不同体质量指数(body mass index,BMI)的慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的康复疗效。方法:52例COPD患者入选, BMI≥24者23例入高BMI组,BMI<24者29例入低BMI组,均给予20周的EDP治疗,比较治疗前后2组患者BODE指数及其分项、动脉血气分析、急性发作次数、心理状态、主观用力程度计分(rate of perceived exertion,RPE)、日常生活活动能力(activities of daily living,ADL)的差异。结果:①20周EDP干预后,高BMI组在BODE指数及其分项、急性发作次数、动脉血气分析、心理状态、RPE、ADL较低BMI组有明显改善(均P<0.05)。②高BMI组治疗前后自身比较,在一秒钟用力呼气肺活量预计值(forced expiratory vital capacity in one second expected,FEV1%)、6 min步行距离(6 minutes walking distance,6MWD)、改良的英国医学研究委员会呼吸困难量表(modified Medical Research Council dyspnea scale,MMRC)、BMI、BODE、pH、动脉氧分压(arterial oxygen pressure,PaO_2)、汉密尔顿抑郁量表(Hamilton depression rating scale for depression,HRSD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、急性发作次数、RPE、ADL明显改善(均P<0.05)。③低BMI组治疗前后自身比较,在MMRC、BODE、HRSD、HAMA、RPE、ADL明显改善(均P<0.05)。结论:对于20周的EDP治疗,高BMI的COPD患者较低BMI患者在BODE指数及其分项、动脉血气分析、急性发作次数、RPE、ADL的疗效明显。

Objective To evaluate the therapeutic efficacy of external diaphragm pacing(EDP) on chronic obstructive pulmonary disease(COPD) patients with different body mass index(BMI). Methods Fifty two patients with COPD were divided into two groups according to BMI. Changes of BODE index, arterial blood gas analysis, rate of exacerbation, psychological state, rate of perceived exertion(RPE) and activities of daily living(ADL) were compared between the two groups before and after treatment with EDP for 20 weeks. Results ① After 20 weeks of EDP, the differences of parameters in high-BMI group such as BODE, rate of exacerbation, arterial blood gas analysis, psychological state and ADL improved significantly when compared with low-BMI group(all P<0.05).② Compared with self-contrast in high-BMI group, the differences of parameters such as forced expiratory vital capacity in one second(FEV1%) expected, 6 minutes walking distance(6 MWD), modified Medical Research Council dyspnea scale(MMRC), BMI, BODE, pH, arterial oxygen pressure(PaO2),Hamilton depression rating scale for depression(HRSD), Hamilton anxiety scale(HAMA), rate of exacerbation, RPE and ADL improved significantly after treatment(all P<0.05).③ In low-BMI group, the differences of parameters such as MMRC, BODE, HRSD, HAMA, RPE and ADL improved significantly after treatment(all P<0.05). Conclusions The therapeutic efficacy of 20-week EDP on COPD patients with high-BMI improved significantly the BODE index, arterial blood gas analysis, rate of exacerbation, psychological state, RPE and ADL.