家庭肺康复对结核后肺病患者通气动力学和小气道功能障碍的影响

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2025-06-14 DOI:10.1016/j.jctube.2025.100542

Iasmim Maria Pereira Pinto Fonseca , Samantha Gomes de Alegria , Jéssica Gabriela Messias Oliveira , Thaís Souza Rodrigues , Carolina Alves Osório da Silva Chagas , Alícia Sales Carneiro , Walter Costa , Ana Paula Santos , Thiago Thomaz Mafort , Agnaldo José Lopes

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引用次数: 0

摘要

随着世界朝着消除结核病的方向发展，仍有大量结核病幸存者面临结核病并发症的沉重负担。然而，目前缺乏针对这一人群的基本肺康复计划（PRP）。本研究旨在评估家庭PRP （HBPRP）对PTLD （pwPTLD）患者肺力学、运动能力和生活质量（QoL）的影响。方法对行HBPRP治疗3个月的pwPTLD患者进行准实验研究。在HBPRP之前和之后，进行以下评估：生活质量使用圣乔治呼吸问卷（SGRQ），一般疲劳使用慢性疾病治疗疲劳功能评估（fact - f），握力（HGS），肺功能和功能运动能力使用Glittre-ADL测试（TGlittre）结合动态通气测量。结果hbprp前后比较，呼吸储备时间[208 (194-249)vs. 184（153-211）秒，P = 0.004]和呼吸储备时间[56 (34-71)vs. 58 (39-73) %, P = 0.032]显著增加，试验结束吸气量降低[1.4 (0.9-2.3)vs. 1.6 (1.1-2.6) L, P = 0.030]。虽然没有观察到肺量参数的增加，但呼吸振荡测量法测量的小气道功能障碍（SAD）有所改善。在SGRQ的活动域和影响域中观察到改进。然而，HBPRP后FACIT-F HGS未见明显变化。结论HBPRP可改善pwPTLD患者的运动耐量、生活质量和SAD，但对全身疲劳和HGS无影响。因此，结核病规划应确保为pwPTLD提供PRP，包括HBPRP。

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Effect of home-based pulmonary rehabilitation on ventilation dynamics and small airway dysfunction in people with post-tuberculosis lung disease

Background

As the world moves toward eliminating tuberculosis (TB), there is a large population of TB survivors who still face a significant burden of TB complications. However, basic pulmonary rehabilitation program (PRP) packages for this population are currently lacking. This study aimed to evaluate the effect of home-based PRP (HBPRP) on lung mechanics, exercise capacity, and quality of life (QoL) in people with PTLD (pwPTLD).

Methods

This is a quasi-experimental study in pwPTLD who underwent HBPRP for 3 months. Before and after HBPRP, the following assessments were performed: QoL using the St George’s Respiratory Questionnaire (SGRQ), general fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), handgrip strength (HGS), pulmonary function, and functional exercise capacity using the Glittre-ADL test (TGlittre) coupled with measurement of dynamic ventilation.

Results

When comparing pre- and post-HBPRP values, there was a significant increase in TGlittre time [208 (194–249) vs. 184 (153–211) seconds, P = 0.004] and breathing reserve [56 (34–71) vs. 58 (39–73) %, P = 0.032], and a reduction in end-of-test inspiratory capacity [1.4 (0.9–2.3) vs. 1.6 (1.1–2.6) L, P = 0.030]. Although no increase in spirometric parameters was observed, there was an improvement in small airway dysfunction (SAD) as measured by respiratory oscillometry. Improvements were observed in the Activity and Impacts domains of the SGRQ. However, no significant changes were noted in FACIT-F or HGS after HBPRP.

Conclusions

In pwPTLD, HBPRP improves exercise tolerance, QoL, and SAD, with no effect on general fatigue and HGS. Therefore, TB programs should ensure the availability of PRP for pwPTLD, including HBPRP.

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.