呼吸肌功能锻炼对老年慢性阻塞性肺疾病合并肺动脉高压患者ET-1、VEGF的影响

Effect of respiratory muscle exercise on ET-1 and VEGF in elderly patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension

目的探讨呼吸肌功能锻炼对老年慢性阻塞性肺疾病(COPD)合并肺动脉高压(PAH)患者肺功能和内皮素-1(ET-1)、血管内皮生长因子(VEGF)的影响。方法选取2018年1月至2021年1月在海南省定安县人民医院呼吸内科就诊的160例稳定期COPD合并PAH患者,随机分为常规治疗组及呼吸肌锻炼组,每组各80例。常规治疗组给予祛痰、吸氧等常规治疗,呼吸肌锻炼组在常规治疗的基础上联合呼吸肌功能锻炼。采用酶联免疫吸附试验(ELISA)检测两组患者ET-1、VEGF水平,比较两组患者肺功能及ET-1、VEGF水平的差别。结果两组干预前第一秒呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、ET-1、VEGF比较,差异均无统计学意义(P>0.05)。干预后,呼吸肌锻炼组FEV1、FEV1/FVC水平高于常规治疗组,而ET-1、VEGF水平低于常规治疗组,差异均有统计学意义(P<0.05)。结论呼吸肌功能锻炼能改善COPD合并PAH患者肺功能,降低血清ET-1、VEGF水平,有助于改善PAH病情。

Objective To investigate the effect of respiratory muscle exercise on endothelin-1(ET-1)and vascular endothelial growth factor(VEGF)in elderly patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary hypertension(PAH).Methods A total of 180 patients with stable COPD complicated with PAH treated in the Department of Respiratory Medicine of People′s Hospital of Ding′an County from January 2018 to January 2021 were randomly divided into the routine treatment group(n=80)and the respiratory muscle exercise group(n=80).The routine treatment group was given oxygen inhalation and other conventional treatment,and the respiratory muscle exercise group was combined with respiratory muscle function exercise.Serum ET-1 and VEGF levels were measured by enzyme-linked immunosorbent assay(ELISA),the lung function and the differences of ET-1 and VEGF between the two groups were compared.Results There were no differences in the first second expiratory volume(FEV1),forced expiratory volume/forced vital capacity(FEV1/FVC),ET-1 and VEGF between the two groups before treatment(P>0.05).After treatment,the FEV1 and FEV1/FVC in the respiratory muscle exercise group were higher than those in the routine treatment group,while ET-1 and VEGF were lower than those in the routine treatment group,with statistical significance(P<0.05).Conclusion Respiratory muscle exercise could reduce the levels of serum ET-1 and VEGF in patients with COPD complicated with PAH,which may improve the condition of PAH.