摘要目的:探讨肺康复锻炼对老年慢性阻塞性肺病(chronic obstructive pulmonary disease，COPD)稳定期患者的焦虑抑郁和主客观睡眠质量的影响。方法:2018年2月至2019年2月选取120例老年COPD稳定期患者，随机分为试验组(肺功能康复锻炼联合COPD常规治疗)和对照组(单纯COPD常规治疗)各60例，干预8周。治疗前后分别采用汉密尔顿焦虑量表(Hamilton anxiety scale，HAMA)评估焦虑情绪，采用汉密尔顿抑郁量表(Hamilton depression scale，HAMD)评估抑郁情绪，采用匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index，PSQI)和睡眠日志评定主观睡眠质量，多导睡眠监测仪监测客观睡眠质量。采用SPSS 21.0软件对数据进行分析处理。采用χ 2检验、独立样本 t检验和配对 t检验进行统计分析。 结果:干预8周后，试验组HAMA、HAMD评分均低于对照组[HAMA(7.57±3.19)分，(10.15±4.89)分；HAMD(8.22±4.73)分，(10.60±6.49)分]( t＝-3.428， P＝0.001； t＝-2.300， P＝0.023)，合并焦虑情绪患者减少(χ 2＝7.566， P＝0.006)；干预后试验组主观睡眠潜伏期较对照组缩短[(42.00±9.88)min，(47.25±10.27)min]( t＝-2.854， P＝0.005)、主观睡眠效率较对照组高[(76.00±4.50)%，(74.00±5.20)%]( t＝2.272， P＝0.025)、客观睡眠潜伏期较对照组缩短[(28.02±5.59)min，(32.95±6.21)min]( t＝-4.575， P<0.05)。 结论:肺康复锻炼可以改善老年COPD稳定期患者焦虑抑郁情绪，并改善主客观睡眠质量。

abstractsObjective:To investigate the effects of pulmonary rehabilitation on anxiety/depression and subjective/objective sleep quality of elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods:From February 2018 to February 2019, 120 elderly patients with stable COPD were selected and randomly divided into the experimental group (pulmonary rehabilitation exercise combined with conventional COPD treatment) and the control group (simple COPD conventional treatment). Sixty cases in each group were intervened for 8 weeks. Before and after treatment, Hamilton anxiety scale (HAMA) was used to evaluate anxiety, Hamilton depression scale(HAMD)was used to evaluate depression, Pittsburgh sleep quality index(PSQI)and sleep log were used to evaluate subjective sleep quality, and objective sleep quality was monitored by multi-channel sleep monitor.SPSS 21.0 software was used to analyze and process the data. Chi square test, independent sample t test and paired t test were used for statistical analysis. Results:After 8 weeks of intervention, the HAMA and HAMD scores of the experimental group were lower than those of the control group (HAMA: (7.57±3.19) vs (10.15±4.89), t=-3.428, P=0.001; HAMD: (8.22±4.73) vs (10.60±6.49), t=-2.300, P=0.023). COPD patients with anxiety decreased (χ 2=7.566, P=0.006). After treatment, the subjective sleep latency of the experimental group was shorter than that of the control group ((42.00±9.88)min vs (47.25±10.27)min, t=-2.854, P=0.005). The subjective sleep efficiency was higher than that of the control group ((76.00±4.50)% vs (74.00±5.20)%, t=2.272, P=0.025), and the objective sleep latency was shorter than that of the control group ((28.02±5.59)min vs (32.95±6.21)min, t=-4.575, P<0.05). Conclusion:Pulmonary rehabilitation exercise can improve the anxiety and depression of elderly patients with stable COPD, and improve the subjective and objective sleep quality.