稳定期慢性阻塞性肺疾病患者体力活动水平的影响因素分析

Analysis of influencing factors of physical activity levels in patients with stable chronic obstructive pulmonary disease

目的探究稳定期慢性阻塞性肺疾病患者体力活动水平与其血气分析、肺功能的关系。方法回顾性选取2021年1月至2022年4月于福建中医药大学附属第三人民医院肺病科就诊的103例慢性阻塞性肺疾病患者为研究对象,按患者体力活动水平进行分组,分为高体力组、中体力组和低体力组。比较三组患者的一般临床资料、血气分析及肺功能情况。结果103例慢性阻塞性肺疾病患者中高体力活动水平28例、中度体力活动水平59例、低体力活动水平16例。经过单因素分析,三组患者年龄、动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))、第1秒用力呼气容积(FEV_(1))、最大呼气流速(PEF)、一秒率[FEV_(1)/用力肺活量(FVC)]、6 min步行试验(6MWD)、核转录因子(NF-κB)及细胞黏附分子-1(ICAM-1)比较,差异有统计学意义(P<0.05)。PaO_(2)、Sa O_(2)、FEV_(1)、PEF、FEV_(1)/FVC、6MWD与体力活动水平呈正相关,PaCO_(2)、NF-κB、ICAM-1与体力活动水平呈负相关(P<0.05)。进行多元线性回归分析,患者PaCO_(2)、NF-κB、ICAM-1是体力活动水平的独立危险因素,PaO_(2)、SaO_(2)、FEV_(1)、PEF、FEV_(1)/FVC、6MWD是体力活动水平的保护因素(P<0.05)。结论PaO_(2)、SaO_(2)、FEV_(1)、PEF、FEV_(1)/FVC、6MWD指标高水平表达是体力活动水平的保护因素,PaCO_(2)、NF-κB、ICAM-1高水平表达是体力活动水平的独立危险因素,反映了体力活动水平越高,肺功能恢复越好。临床上可根据患者上述指标因素制订个性化康复活动。

Objective To explore the relationship between physical activity levels,blood gas analysis,and lung function in patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 103 patients with chronic obstructive pulmonary disease from January 2021 to April 2022 in the pulmonary Department of the Third People’s Hospital Affiliated to Fujian University of Chinese Medicine were retrospectively selected as the study objects.According to the level of physical activity of patients,they were divided into a high physical strength group,a moderate physical strength group and a low physical strength group.The general clinical data,blood gas analysis,and lung function of the three groups of patients were compared.Results There were 28 patients with high physical activity levels,59 patients with moderate physical activity levels,and 16 patients with low physical activity levels in these 103 patients with chronic obstructive pulmonary disease.After univariate analysis,the age,partial pressure of oxygen in arterial-blood(PaO_(2)),carbon dioxide partial pressure(PaCO_(2)),oxygen saturation(SaO_(2)),forced expiratory volume in 1 second(FEV_(1)),peak expiratory flow(PEF),FEV_(1)/forced vital capacity(FVC),6-minute walking test(6MWD),nuclear factor-kappa B(NF-κB)and intercellular adhesion molecule-1(ICAM-1)of the three groups of patients were significantly different(P<0.05).PaO_(2),SaO_(2),FEV_(1),PEF,FEV_(1)/FVC and 6MWD were positively correlated with physical activity levels,while PaCO_(2),NF-κB and ICAM-1 were negatively correlated with physical activity levels(P<0.05).Multivariate linear regression analysis showed that PaCO_(2),NF-κB and ICAM-1 of patients were independent risk factors for physical activity levels,while PaO_(2),SaO_(2),FEV_(1),PEF,FEV_(1)/FVC and 6MWD were protective factors for physical activity levels(P<0.05).Conclusion High levels of PaO_(2),SaO_(2),FEV_(1),PEF,FEV_(1)/FVC and 6MWD indicators are protective factors for physical activity levels,while high-level expressions of PaCO_(2),NF-κB and ICAM-1 are independent risk factors for physical activity levels,reflecting that the higher the level of physical activity,the better the recovery of lung function.In clinical practice,personalized rehabilitation activities can be developed based on the above indicators and factors of patients.