有氧运动对慢性阻塞性肺疾病稳定期患者外周血调节性T细胞亚群与心肺运动功能的干预研究

The changes of Treg cells and cardiopulmonary exercise test before and after aerobic exercise in patients with chronic obstructive pulmonary disease

目的:探讨COPD稳定期患者有氧运动前后调节性T细胞(Treg)亚群细胞及心肺运动功能变化情况,研究有氧运动改善COPD稳定期患者临床症状、促进COPD患者康复的机制。方法:选取2016年1月-2017年12月我院住院COPD稳定期患者为研究对象。COPD对照组30例用12周吸氧、化痰、舒张支气管等常规药物治疗,COPD试验组30例用常规治疗同时施加有氧运动干预12周。比较患者治疗前后外周血中的Treg细胞亚群比例、IL-17和TGF-β表达水平与心肺运动功能变化情况。结果:有氧运动干预后,试验组Treg细胞亚群比例较干预前及对照组治疗后升高,且IL-17及TGFβ表达水平降低(P<0.05);峰值公斤摄氧量(Peak VO2/kg)、峰值功率(Peak Power)、峰值CO2排出量(Peak VCO2)较干预前及对照组药物治疗后得到一定改善(P<0.05)。结论:有氧运动对COPD稳定期患者具有调节免疫功能、减轻炎症反应、改善肺功能和促进肺康复的作用,为临床COPD稳定期患者的有氧运动在免疫学上提供理论依据。

Objective:To analyze the changes of Treg cells and cardiopulmonary function exercise test(CPET) before and after aerobic exercise in patients with chronic obstructive pulmonary disease(COPD), and the mechanism of improving clinical symptoms and promoting recovery.Method: Sixty inpatients with stable COPD were selected. 30 patients in the control group were given the stable COPD drug following the drug instruction for 12-week. 30 patients in the experimental group were treated with drug and aerobic exercise for 12-week.The index of Treg cells, cytokines and CPET were compared between groups before and after treatment.Result: After aerobic exercise intervention, the proportion of Treg cells in the experimental group was higher than that before intervention, and after drug therapies in control group, and the expression of IL-17 and TGF-βdecreased(P<0.05),the Peak VCO2/kg,Peak power CO2 emissions and Peak WR improved compared with those before intervention and after drug therapies in the control group(P<0.05).Conclusion: Aerobic exercise can regulate immune function, alleviate inflammatory reaction, improve lung function, promote lung recovery in stable COPD patients. These maybe immunological theoretical basis of aerobic exercise in patients with stable COPD.