ASSESSMENT OF THE EFFECT OF PULMONARY REHABILITATION ON THE RESPIRATORY MUSCLES AND REGIONAL THORACIC MOTION BY USING NEW IMAGING TECHNIQUES AND MOLECULAR BIOLOGICAL METHOD IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASES (COPD)
采用新成像技术和分子生物学方法评估肺康复对慢性阻塞性肺病(COPD)患者呼吸肌和胸廓运动的影响
基本信息
- 批准号:11835039
- 负责人:
- 金额:$ 2.3万
- 依托单位:
- 依托单位国家:日本
- 项目类别:Grant-in-Aid for Scientific Research (C)
- 财政年份:1999
- 资助国家:日本
- 起止时间:1999 至 2000
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
To assess the effect of pulmonary rehabilitation on the respiratory muscles and regional respiratory mechanics, the six-week comprehensive pulmonary rehabilitation program supported by an interdisciplinary team was organized and conducted in 18 patients with COPD (age 67±7[SD]years, FEVl 1.05±0.44 L). The program consists of patient education, physiotherapy, exercise training, and nutritional consultation. The significant improvements in dyspnea (100mm VAS 41±24 to 28±20 mm), quality of life (SGRQ Score 47.8±12.1 to 39.1±15.5), TGV (5.99±0.93 to 5.64±1.06 L), respiratory muscle strength (PImax -58±16 to -71±19, PE max 149±42 to 162±39 cmH_2O), 6MWD (435±63 to 471±51m) were obtained. The dynamic breathing magnetic resonance imaging (MRI) was performed in ten COPD patients with before and after the rehabilitation. The images were acquired with field echo method at sagittal and coronal planes over three slow deep respiratory cycles (18 sec / cycle, 48 sequential image, scanning time : 1se … More c / image). Ten patients had six week outpatient (n=8) or two week inpatient (n=2) program. A significant increase in motion (Δ = D inspiration - D expiration [D : distance]) was observed in the upper rib cage (coronal and right sagittal plane) and the left diaphragm (left sagittal plane). The coordination among the chest wall expansion, rib cage elevation, widening of the apex, back stretch, and downward displacement of the diaphragm was assessed by using visual score and improvement was also obtained in each plain. It is suggested that the thoracic dynamic MRI may provide quantitative assessment both in initial disorder and post rehabilitation improvement which is otherwise undetectable and it can promote better physiological understanding. To confirm the evidence of the mitochondrial damage in the diaphragm by oxygen-based free radicals, we examined the diaphragms of 26 subjects with pulmonary diseases. The costal parts of diaphragms were obtained within 8 hrs of post mortem. Twenty-four of 26 DNA samples(92%) from diaphragms showed a 5kb deletion of mtDNA regardless of age. However, the effect of pulmonary rehabilitation on oxidative stress was not able to be evaluated since a 5kb deletion of mtDNA in the peripheral blood was not observed in all 18 COPD patients. We are planning the use of more sensitive PCR techniques such as realtime PCR or the biopsied specimens of other skeletal muscles in the near future. Less
为了评估肺康复对呼吸肌和局部呼吸力学的影响,在跨学科团队的支持下,对18名COPD患者(年龄67±7[SD]岁,FEV1 1.05±0.44 L)组织并进行了为期六周的综合肺康复计划。该计划包括患者教育、物理治疗、运动训练和营养咨询。呼吸困难(100mm VAS 41±24 至 28±20 mm)、生活质量(SGRQ 评分 47.8±12.1 至 39.1±15.5)、TGV(5.99±0.93 至 5.64±1.06 L)、呼吸肌力量(PImax -58±16 至 -71±19、PE max)显着改善149±42 至 获得162±39 cmH_2O)、6MWD(435±63至471±51m)。对10名COPD患者康复前后进行动态呼吸磁共振成像(MRI)检查。这些图像是在三个缓慢的深呼吸周期(18 秒/周期,48 个连续图像,扫描时间:1se … 更多 c/图像)中通过矢状面和冠状面的场回波方法获取的。 10 名患者接受了为期六周的门诊治疗 (n=8) 或两周的住院治疗 (n=2) 计划。在上胸腔(冠状面和右矢状面)和左膈肌(左矢状面)中观察到运动显着增加(Δ = D 吸气 - D 呼气 [D:距离])。通过视觉评分评估胸壁扩张、胸腔抬高、心尖加宽、向后伸展和横膈膜向下移位之间的协调性,并且在每个平原中也获得了改善。建议胸部动态 MRI 可以对初始疾病和康复后改善提供定量评估,这是其他方法无法检测到的,并且可以促进更好的生理理解。为了证实氧自由基对膈肌线粒体造成损伤的证据,我们检查了 26 名患有肺部疾病的受试者的膈肌。横膈膜的肋部是在死后 8 小时内获得的。 26 个隔膜 DNA 样本中的 24 个(92%)显示出 5kb 的 mtDNA 缺失,无论年龄如何。然而,由于在所有 18 名 COPD 患者中均未观察到外周血中 5kb mtDNA 缺失,因此无法评估肺康复对氧化应激的影响。我们计划在不久的将来使用更灵敏的 PCR 技术,例如实时 PCR 或其他骨骼肌的活检样本。较少的
项目成果
期刊论文数量(14)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
十合晋作: "Negative Expiratory Pressure(NEP)法-気管支喘息発作時における気流閉塞の非侵襲的評価-"臨床呼吸生理. 32. 15-18 (2000)
Shinsaku Jugoi:“呼气负压 (NEP) 方法 - 支气管哮喘发作期间气流阻塞的无创评估 -”《临床呼吸生理学》32. 15-18 (2000)。
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
植木純: "タバコの体への影響"Home Oxygen Therapy. 22. 6-7 (2001)
Jun Ueki:“烟草对身体的影响”家庭氧气疗法。22. 6-7 (2001)。
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
植木 純: "COPDの治療ガイドライン"Prog.Med. 20. 796-800 (2000)
Jun Ueki:“COPD 治疗指南”Prog.Med 20. 796-800 (2000)
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
檀原 高: "呼吸器疾患の診かた考え方 6.超音波検査"中外医学社. 97-100 (1999)
Takashi Danhara:“关于如何诊断呼吸系统疾病的思考6.超声检查”Chugai Igakusha 97-100(1999)。
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
植木 純: "慢性閉塞性肺疾患診療におけるQOLの評価"臨床成人病. 31. 73-77 (2001)
Jun Ueki:“慢性阻塞性肺疾病治疗中的生活质量评估”《临床成人疾病》31. 73-77 (2001)。
- DOI:
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- 影响因子:0
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UEKI Jun其他文献
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{{ truncateString('UEKI Jun', 18)}}的其他基金
Development of the new evidence-based Western style self-management education tools and system for patients with chronic respiratory disease.
为慢性呼吸道疾病患者开发新的循证西式自我管理教育工具和系统。
- 批准号:
21592780 - 财政年份:2009
- 资助金额:
$ 2.3万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
The standardization and evaluation of the effects of respiratory conditioning technique of pulmonary rehabilitation
肺康复呼吸调理技术效果标准化及评价
- 批准号:
19500461 - 财政年份:2007
- 资助金额:
$ 2.3万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
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