胡丹平 朱慧琳 颜金农 王霞 张秉欣 赵德军

[摘要] 目的 探討肺康复训练对中重度慢性阻塞性肺疾病急性加重患者BODE指数及NLR、PLR的影响。 方法 选取慢性阻塞性肺疾病急性加重期患者165例为研究对象，随机分为肺康复训练组与对照组，肺康复训练组83例，对照组82例。肺康复训练组在对照组常规治疗基础上增加肺康复训练。回顾性分析比较肺康复训练组与对照组治疗前后BODE指数、NLR、PLR变化，分析肺康复训练对中重度慢性阻塞性肺疾病急性加重期患者BODE指数、NLR、PLR的影响。 结果 肺康复训练组在治疗后BODE指数均较治疗前明显下降，差异有统计学意义（P<0.05）。治疗后肺康复训练组与对照组比较，BODE指数下降程度更加明显，差异有统计学意义（P<0.05）。肺康复训练组治疗后较治疗前NLR、PLR值明显降低，差异有统计学意义（P<0.05）。治疗后肺康复训练组与对照组NLR、PLR值比较下降更明显，差异有统计学意义（P<0.05）。 结论 肺康复训练能够改善中重度COPD患者BODE指数，提升运动耐力、生存质量，对肺功能的改善作用不大。肺康复训练可以降低中重度COPD患者NLR、PLR值，改善炎症反应，有助于患者减少急性加重风险。

[关键词] 肺康复;慢性阻塞性肺疾病;BODE指数;NLR;PLR

[中图分类号] R563.9          [文献标识码] A          [文章编号] 1673-9701（2021）36-0017-04

Effect of pulmonary rehabilitation training on NLR and PLR in patients with moderate and severe chronic obstructive pulmonary disease

HU Danping   ZHU Huilin   YAN Jinnong   WANG Xia   ZHANG Bingxin   ZHAO Dejun

The Second Department of Respiratory， the First People's Hospital of Fuyang District in Hangzhou， Hangzhou   311400， China

[Abstract] Objective To explore the effects of pulmonary rehabilitation training on BODE index， NLR and PLR of patients with acute exacerbation of moderate and severe chronic obstructive pulmonary disease. Methods A total of 165 patients with acute exacerbation of chronic obstructive pulmonary disease were selected as the research subjects， and randomly divided into the pulmonary rehabilitation training group and the control group， with 83 patients in the pulmonary rehabilitation training group and 82 patients in the control group. The pulmonary rehabilitation training was added to the pulmonary rehabilitation training group based on the routine treatment in the control group. The changes of BODE indexes， NLR and PLR in the pulmonary rehabilitation training group and the control group before and after treatment were retrospectively analyzed and compared， and the effects of pulmonary rehabilitation training on BODE indexes， NLR and PLR in patients with moderate and severe chronic obstructive pulmonary disease at the acute exacerbation stage were analyzed. Results The BODE indexes in the pulmonary rehabilitation training group were decreased significantly after treatment compared with those before treatment， and the differences were statistically significant（P<0.05）. After treatment， the BODE indexes in the pulmonary rehabilitation training group were decreased more obviously than those in the control group， with statistically significant differences （P<0.05）. After treatment， NLR and PLR values in the pulmonary rehabilitation training group were significantly lower than those before treatment， with statistically significant differences （P<0.05）. After treatment， NLR and PLR values in the pulmonary rehabilitation training group were decreased more obviously compared with those in the control group， with statistically significant differences （P<0.05）. Conclusion Pulmonary rehabilitation training can improve the BODE index， exercise endurance and quality of life in patients with moderate and severe COPD， but has little effect on pulmonary function improvement. Pulmonary rehabilitation training can reduce NLR and PLR values， improve inflammatory response， and help patients reduce the risk of acute exacerbation.

[Key words] Pulmonary rehabilitation; Chronic obstructive pulmonary disease; BODE index; NLR; PLR

慢性阻塞性肺疾病（Chronic obstructive pulmonary diseases，COPD），简称慢阻肺，是常见的慢性呼吸道疾病之一[1]。COPD的临床特点是持续的呼吸道症状和气流受限，与长期暴露于有害颗粒或气体有关。慢性气道炎症是COPD的病理基础，广泛存在于肺实质、肺血管及气道[2]。COPD的发病机制尚未完全清楚，炎症反应是COPD发生发展的重要内容，参与炎症反应的炎性细胞有肺泡巨噬细胞、中性粒细胞、淋巴细胞等[3]。……