RÉSUMÉ
Objective To explore the effects of lung rehabilitation using Spiro-tiger training apparatus on the respiratory mechanics and airway remodeling in patients with chronic obstructive pulmonary disease(COPD)in stable stage.Methods Ninety-three stable COPD patients admitted to Nanxiang Branch of Shanghai Ruijin Hospital were randomly divided into control group(46 cases)and observation group(47 cases).Control group was treated with the training for pursed lips breathing and abdominal breathing,and observation group was trained with Spiro-tiger training apparatus in addition to the treatment given to control group.Both groups were intervened continuously for 9 weeks.The two groups were compared in terms of respiratory mechanics(respiratory frequency,tidal volume,minute ventilation,and peak respiratory pressure),airway remodeling[matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF),and transforming growth factor-β1(TGF-β1)],and lung function[forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),and FEV1/FVC],blood gas analysis indexes[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)],6-minute walking distance(6MWD)and health status[Borg scale and St.George's respiratory questionnaire(SGRQ)].The patients were followed up for 6 months,and the incidence of acute exacerbation of COPD was recorded.Results After 9 weeks of intervention,compared with control group,observation group had lower peak respiratory frequency and respiratory pressure,and higher tidal volume(P<0.05).There was no significant difference in minute ventilation between two groups(P>0.05).The levels of MMP-9,VEGF,TGF-β1 and PaCO2 were lower,and FVC,FEV1,FEV1/FVC and PaO2 were higher in observation group than in control group(P<0.05).Observation group had longer 6MWD,and lower Borg score and SGRQ score as compared with control group(P<0.05).After 6-month follow-up,the incidence of COPD acute exacerbation in observation group was lower than that in control group(4.26%vs19.57%,P<0.05).Conclusion Lung rehabilitation using Spiro-tiger training apparatus can effectively improve respiratory mechanics,lung function,blood gas analysis indexes and health status in stable COPD patients,alleviate airway remodeling,and avoid acute exacerbation of COPD.
RÉSUMÉ
Objective To investigate the relationship between Ambulatory Arterial Stiffness Index (AASI)and kidney damage or carotid endarterectomy damage in hypertension patients.Methods One hundred and forty-nine patients with hypertension but without diabetes or other arteriosclerosis diseases were enrolled.Forty-eight healthy volunteers during the same period were enrolled as control group.All participants'24 h-ambulatory blood pressure monitoring(ABPM),urinary albumin/creatinine ratio(ACR)and IMT were recorded and AASI was calculated.Then the correlation between AASI and ACR or IMT were calculated.Results There were significant differences in the urinary albumin/creatinine ratio(46.34 vs.33.52)(P ＜ 0.05),microalbuminuria incidence(41％ vs.21％),Carotid intima-media thickness([0.90 ±0.21]mm vs.[0.83 ±0.20]mm),abnormal incidence(72％ vs.60％)and AAS1(0.50 ± 0.16 vs.0.42 ± 0.17)(P ＜ 0.01)between the subjects with hypertension and those without.The AASI were positively correlated with ACR and IMT in hypertension patients.Compared with healthy subjects,the AASI were significantly increased in the patients with abnormal CR and IMT(P ＜0.05 、P ＜0.01).Conclusion The AASI were correlated with kidney damage and carotid endarterectomy damage in hypertension patients.