阶梯式运动康复对老年稳定期慢性阻塞性肺疾病患者呼吸力学及运动耐力的影响OA

Objective To explore the impact of stepwise exercise rehabilitation on respiratory mechanics and exercise tolerance in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 80 elderly patients with stable COPD admitted from April to October 2024 were selected as the study subjects.The patients were randomly divided into an observation group and a control group using a random number table method,with 40 patients in each group.Both groups received conventional drug therapy,while the control group received conventional exercise rehabilitation training,and the observation group received stepwise exercise rehabilitation training.Both groups underwent continuous training for 8 weeks.The pulmonary function indicators[percentage of predicted forced expiratory volume in 1 second(FEV1％predicted),forced vital capacity(FVC),peak expiratory flow rate(PEF)],respiratory mechanics indicators[respiratory rate,tidal volume,peak airway pressure(Ppeak)],static and exercise blood oxygen indexes[arterial oxygen saturation(SaO2),oxygen desaturation index(ODI),hypoxemia ratio],biochemical indicators[peripheral blood procalcitonin(PCT),platelet/lymphocyte ratio(PLR),interleukin-6(IL-6),neutrophil/lymphocyte ratio(NLR)],exercise tolerance[6-minute walking distance(6MWD)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)],quality of life[St.George's Hospital Respiratory Questionnaire(SGRQ)],and incidence of acute exacerbation events were compared between the two groups.Results After training,the observation group had lower respiratory rate and Ppeak,and higher FVC,tidal volume,FEV1％,and PEF compared with the control group(P＜0.01).After training,the ODI and hypoxia ratio in the observation group were lower than those in the control group(P＜0.01),and no significant difference in SaO2 was found between the two groups(P＞0.05).After training,the levels of peripheral blood PCT,PLR,IL-6 and NLR in the observation group were lower than those in the control group(P＜0.01).The observation group presented lower PSQI,SGRQ scores and higher 6MWD than the control group after training(P＜0.01).The incidence of acute exacerbation events during rehabilitation training in the observation group was[2.50％(1/40)],which was lower than[20.00％(8/40)]in the control group(P＜0.05).Conclusion The application of stepwise exercise rehabilitation in elderly stable COPD patients can improve that blood oxygen state of patient during exercise,reduce the level of inflammation,adjust respiratory mechanics,improve pulmonary function,enhance exercise tolerance,and thus improve patients' quality of life and sleep quality,with good safety for clinical application.