CAJ | 학술논문

目的观察有氧运动联合噻托溴铵治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压的临床疗效.方法采用随机数字表法将98例肺功能Ⅱ-Ⅲ级的COPD合并肺动脉高压稳定期患者分为对照1组(30例)、对照2组(37例)及观察组(31例).对照1组患者规律性吸入沙美特罗替卡松粉剂,并根据患者病情给予抗生素、对症药物及稀释痰液药物治疗;对照2组患者在上述治疗基础上给予噻托溴铵干粉吸入;观察组患者在对照2组治疗基础上增加有氧运动.于治疗前、治疗6个月后分别采用6 min步行距离(6MWD)、慢性阻塞性肺疾病评估测试(CAT)及间接肺动脉收缩压(PASP)对各组患者进行疗效评定.结果 3组患者分别经6个月治疗后,发现观察组6MWD[(302.7 ±27.5)m]、CAT评分[(10.7±2.9)分]、间接PASP[(34.4±3.8)mmHg]均明显优于对照1组及对照2组水平,组间差异均具有统计学意义(P＜0.05).结论规律性吸入噻托溴铵粉剂并联合有氧运动治疗COPD合并肺动脉高压患者具有协同作用,能进一步降低患者肺动脉收缩压,减轻疾病症状,提高生活质量.
목적 관찰유양운동연합새탁추안치료만성조새성폐질병(COPD)합병폐동맥고압적림상료효.방법 채용수궤수자표법장98례폐공능Ⅱ-Ⅲ급적COPD합병폐동맥고압은정기환자분위대조1조(30례)、대조2조(37례)급관찰조(31례).대조1조환자규률성흡입사미특라체잡송분제,병근거환자병정급여항생소、대증약물급희석담액약물치료;대조2조환자재상술치료기출상급여새탁추안간분흡입;관찰조환자재대조2조치료기출상증가유양운동.우치료전、치료6개월후분별채용6 min보행거리(6MWD)、만성조새성폐질병평고측시(CAT)급간접폐동맥수축압(PASP)대각조환자진행료효평정.결과 3조환자분별경6개월치료후,발현관찰조6MWD[(302.7 ±27.5)m]、CAT평분[(10.7±2.9)분]、간접PASP[(34.4±3.8)mmHg]균명현우우대조1조급대조2조수평,조간차이균구유통계학의의(P＜0.05).결론 규률성흡입새탁추안분제병연합유양운동치료COPD합병폐동맥고압환자구유협동작용,능진일보강저환자폐동맥수축압,감경질병증상,제고생활질량.
Objective To observe effect of aerobic exercise combined with inhalation of tiotropium on patients with stable chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension.Methods A total of 98 patients with stable COPD and grade Ⅱ or Ⅲ pulmonary function complicated with pulmonary hypertension were recruited.They were divided into an observation group (n =31) and two control groups (n =30 and 37).Patients in control group 1 inhaled shahmette and fluticasone powder,and antibiotics as well as apophlegmatisant were also used in accordance with the demands of the patient's condition.Patients of in control group 2 inhaled tiotropium dry powder and accepted other therapeutic measures equivalent to those of control group1.The patients in the observation group were given aerobic exercise in addition to other therapeutic measures equivalent to those of control group 2.Six-minute walk test distances,pulmonary arterial systolic pressure and chronic obstructive pulmonary disease assessment test scores were compared after 6 months of treatment,among the groups and against the baseline values before treatment.Results After 6 months of treatment the average 6-minute walk distance,chronic obstructive pulmonary disease assessment score and pulmonary arterial systolic pressure of the observation group were all significantly better than for either of the control groups.Conclusions Inhaling tiotropium dry powder combined with aerobic exercise can reduce pulmonary artery systolic pressure and improve the symptoms as well as the quality of life for patients with stable COPD complicated by pulmonary hypertension.