| Background and Objective: chronic obstructive pulmonary disease(COPD),a common chronic respiratory disease characterized by persistent respiratory symptoms and airflow restriction,has become one of the three leading causes of death in the world.Acute exacerbations(AE)are adverse events of COPD exacerbations,which lead to extra-pulmonary symptoms such as peripheral muscle dysfunction,decline in exercise endurance and systemic hypofunction.Even with the best and regulated medication during hospitalization,some patients do not fully return to baseline physical function and health status prior to exacerbation 3 months after discharge.Respiratory rehabilitation is an effective non-drug treatment to improve exercise ability,but the timing and mode of intervention are still controversial.This study aims to review and find the factors affecting exercise endurance of patients with AECOPD,and analyze the influencing factors of significant improvement in exercise ability after drug and respiratory rehabilitation treatment and the relationship between exercise endurance improvement and prognosis,to provide basis for early rehabilitation intervention in clinic.Method: A total of 205 patients with AECOPD who underwent early stage Zheng’s Supine Rehabilitation Exercise(ZSRE)in our hospital from May 2019 to August2021 were retrospectively selected,and 79 met the inclusion criteria.Relevant data and clinical characteristics of the patients were collected.SPSS25.0 was used for statistical analysis.1.Explore the related factors of sports endurance: The 6-minute walking distance at admission was used as the evaluation criterion for exercise endurance,and correlation analysis was conducted with general data,test results and clinical characteristics.Pearson correlation analysis was used for correlation test of measurement data consistent with normal distribution,while Spearman correlation analysis was used for correlation test of non-normal distribution,and correlation coefficient was represented by r.2.Factors influencing the improvement of exercise endurance: Patients were divided into the improved group and the non-improved group according to whether their exercise endurance had increased by more than 30 m from baseline at discharge.logistic univariate analysis was carried out on the general data,test results and clinical characteristics of statistical differences between the two groups.Statistically significant covariables(P<0.1)in univariate analysis were included in binary logistic multivariate regression analysis.3.The relationship between improvement of exercise endurance and prognosis: The hospitalization rate and mortality of acute exacerbation 12 months after discharge were compared between the improved group and the non-improved group.The test methods were Chi-square test or Fisher’s exact probability test,and P < 0.05 was considered statistically significant.Results:1.The 6-minute walking distance was used as the evaluation criteria for exercise endurance,which was correlated with CAT score(r=-0.293,p=0.015),arterial blood partial pressure of CO2(r=-0.356,p=0.002)and arterial blood HCO3-(r=-0.297,p=0.010).2.Univariate analysis showed that the ratio of hospitalized neutrophil >75%,HCO3->27mmol/L and arterial blood partial pressure of CO2 were the influencing factors for the improvement of exercise ability after rehabilitation of AECOPD(P<0.05).The covariates with statistical significance in univariate analysis were included in binary logistic multivariate regression,and there was no statistical difference(P>0.05).3.A total of 2 patients in the improved group(n=30)and the non-improved group(n=49)experienced discomfort during the acute phase of rehabilitation,and both patients improved after treatment.The hospitalization rate and mortality of acute exacerbation within 12 months after discharge were not significantly different between the two groups.Hospitalization and death due to acute exacerbation were defined as poor prognosis,and there was no significant difference in prognosis between the two groups(p>0.05).Conclusion:1.AECOPD exercise endurance was correlated with CAT score,arterial blood partial pressure of CO2 and arterial blood HCO3-.2.Hospitalization neutrophil ratio >75%,HCO3->27mmol/L,and arterial blood partial pressure of CO2 may be the factors affecting the improvement of exercise ability after respiratory rehabilitation of AECOPD.3.No significant difference was found between exercise endurance improvement in acute COPD and hospitalization and mortality of acute exacerbation 12 months after discharge... |
