摘要
本研究验证了呼吸功能障碍的严重程度可能影响肺功能康复的结果。在这项随机、对照研究中,126例慢性阻塞性肺疾病(COPD)患者根据呼吸困难程度按医学研究理事会(MRC)呼吸困难评分分为MRC3/4(中度)组(n=66)和MRC 5(重度)呼吸困难组(n=60)。患者被随机分配到一个为期8周的锻炼+教育(锻炼组)或教育(对照组)。对中度呼吸困难患者的教育和锻炼方案在医院门诊环境中进行。严重呼吸困难患者均在家中治疗。运动组接受了个性化的训练计划。接受运动训练的中度呼吸困难组在穿梭距离上有显著改善;基线(平均值+/-SEM) 191+/-22米,康复后279+/-22米(p<0.001)。接受运动治疗的严重呼吸困难患者的运动表现没有改善。两组对照组患者病情均无改善。 Health status, assessed by the Total Chronic Respiratory Disease Questionnaire score, increased in the moderately dyspnoeic patients receiving exercise from 80+/-18 to 95+/-17 (p<0.0001) after rehabilitation. Much smaller changes were seen in the other three groups. Improvement in exercise performance and health status in patients with chronic obstructive pulmonary disease after an exercise programme depends on the initial degree of dyspnoea.