慢性阻塞性肺疾病患者长期家庭氧疗对肺功能及认知功能影响的研究

Effects of long-term oxygen therapy on pulmonary function and cognitive function in patients with chronic obstructive pulmonary disease

目的 探讨慢性阻塞性肺疾病(COPD)患者配合长期家庭氧疗(LTOT)对肺功能及认知功能的影响。方法 收集确诊为COPD稳定期的患者,根据随机原则分为试验组(配合LTOT)及对照组(未配合LTOT),两组均给予化痰、平喘等常规处理,试验组在其基础上联合LTOT。6个月、12个月后复查肺功能及认知功能,评估相关变化情况。结果 6个月时试验组肺功能第1 s用力呼气量(FEV1)明显高于对照组(P<0.05),用力肺活量(FVC)及最大呼气峰流速值(PEF)差异均无统计学意义(均P>0.05);12个月时试验组FEV1、FVC及PEF均明显高于对照组(均P<0.05)。12个月后试验组蒙特利尔认知评估量表(MoCA)评分明显高于对照组(P<0.05)。对两组COPD患者严重程度进行划分,极重度COPD患者通过LTOT治疗可明显减轻认知功能损害(P<0.05);治疗12个月时对两组肺功能及认知功能进行相关性分析,试验组FEV1/FVC与MoCA评分呈正相关(P<0.05)。结论 LTOT可显著改善稳定期COPD患者肺功能损伤及认知功能下降,对极重度COPD患者认知功能改善更明显,可能是通过改善肺功能从而提高患者的认知功能水平。

Objective To investigate the effect of long-term oxygen therapy(LTOT) on pulmonary function and cognitive function in patients with chronic obstructive pulmonary disease(COPD).Methods Patients with COPD were randomly divided into two groups: the experimental group(with LTOT) and the control group(without LTOT). The two groups were given conventional treatment such as expectorant and antiasthmatic. The observation group was combined with LTOT on the basis of conventional treatment. After 6 months and 12 months to review lung function and assess cognitive function changes. Results At 6 months, the forced expiratory volume in the first second(FEV1) of pulmonary function in the experimental group was significantly higher than that in the control group(P<0.05), and there was no significant difference in forced vital capacity(FVC) and peak expiratory flow(PEF)(allP>0.05). At 12 months, FEV1, FVC and PEF in the experimental group were significantly higher than those in the control group(allP<0.05). After 12 months, Montreal cognitive assessment(MoCA) of the experimental group were significantly higher than that of the control group(P<0.05). The severity of COPD patients in the two groups was divided, LTOT could significantly reduce cognitive impairment in patients with extremely severe COPD(P<0.05). The correlation analysis of pulmonary function and cognitive function was carried out in the two groups after 12 months of treatment. There was a positive correlation between FEV1/FVC and MoCA score in the experimental group(P<0.05).Conclusion LTOT can significantly improve the lung function injury and cognitive function decline in patients with stable COPD, especially in patients with very severe COPD, and it may be through improving lung function to improve the level of cognitive function of patients.