间质性肺病的呼吸康复治疗

Pulmonary rehabilitation for intersitial lung disease

间质性肺病(ILD)是一组异质性慢性呼吸系统疾病,主要表现为劳力性呼吸困难和健康相关生活质量评分下降。ILD运动受限的病生理机制包括限制性通气功能障碍、换气功能障碍、血流动力学异常以及骨骼肌功能障碍。近年来,越来越多的证据表明呼吸康复治疗对ILD安全、有效,能短期内显著改善患者的运动能力、呼吸困难症状和健康相关生活质量评分。该篇综述总结了ILD呼吸康复治疗的研究证据、目前的指南推荐、ILD的呼吸康复治疗个体化的特殊问题以及ILD合并肺动脉高压、ILD急性加重期呼吸康复情况。

Interstitial lung disease (1LD) is a group of heterogenous chronic respiratory diseases characterized by dyspnoea on exertion and decline in health-related quality of life. The pathophysiological mechanisms of exercise limitation include ventilation dysfunction, impaired gas exchange, hemodynamic abnormalities and skeletal muscle dysfunction. In recent years, there have been increasing evidences for safety and availability of pulmonary rehabilitation in patients with ILD. Pulmonary rehabilitation improves exercise capacity, dyspnea and health related quality of life in short term. This review summarizes the evidence for pulmonary rehabilitation in 1LD, outlines the guideline rec on mm end at io ns, highlights special considerations for personalized pulmonary rehabilitation, and discusses pulmonary rehabilitation in 1LD with pulmonary hypertension and acute exacerbation of 1LD.