| Budget Amount *help |
¥2,200,000 (Direct Cost: ¥2,200,000)
Fiscal Year 2001: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 2000: ¥1,300,000 (Direct Cost: ¥1,300,000)
|
|---|
| Research Abstract |
1. Assessment of the effect of pulmonary rehabilitation on air-flow obstruction in patients with chronic obstructive pulmonary disease (COPD) : It has been widely accepted that the measures of air-flow obstruction by using FVC manoeuvre (FEV1, FVC) does not improve as a result of pulmonary rehabilitation in patients with COPD. To assess whether the air-flow limitation during resting tidal breathing is improved by pulmonary rehabilitation, the six week outpatient program was conducted in 17 patients with moderate to severe COPD (age 69±5[SD] years, FEV1 1.02 ± 0.36L). For the assessment of air-flow limitation during tidal breathing, the NEP method which consists of applying negative pressure (-4cmH_2O) at the mouth during resting tidal expiration was used. The significant improvements in dyspnea, 6MWD, PImax, QOL(SGRQ) were obtained. In spite of no decrease in FEV1(1.02 ± 0.36 to 1.0 ± 0.36 L), the air-flow limitation during tidal breathing has been improved significantly (air-flow limi
… More
tation score : 2.2±1.6 to 1.1±1.1). There was no significant change in FRC, RV, RV/TLV(N_2 washout method). However, the decrease in TGV, RVbox, RV/TLCbox were obtained(P<0.01) which might be due to the decrease in dynamic hyperinflation during resting breathing and chest wall elastance. NEP method can provide more sensitive and clinically meaningful parameters in patients with COPD. 2. Evaluation of air-flow limitation during tidal breathing in asthmatic patients with acute exacerbation by using negative expiratory pressure (NEP) method : In acute asthma exacerbation, peak expiratory flow (PEF) measurement induces unpleasant sensation such as cough and bronchoconstriction and obtained values are sometimes inaccurate. In 19 patients with acute exacerbation, tidal expirafory flow limitation by using NEP, SpO_2, dyspnea (VAS) were evaluated in the sitting and supine position before and after the treatment. There was a correlation (r = -0.50, p<0.05) between dyspnea (%VAS) and 50%VT ratio (tidal expiratory flow in the presence of NEP / control tidal expiratory flow at 50%VT) in the sitting position. The increase of air flow limitation was observed in the supine position (decrease in 50%VT ratio and increase in ISV, p<0.05). More than half of patients who showed ISV in the supine position before the treatment had re-exacerbation within two weeks. We conclude that NEP method may be a useful non-invasive tool for the monitoring of air flow limitation in asthmatic patients with acute exacerbation. Less
|
