目的 探究脊髓损伤(spinal cord injury,SCI)患者基础肺功能与日常生活能力的相关性,为临床更好地应用基础肺功能指标指导心肺康复训练、提高患者日常生活能力提供理论依据.方法 回顾性分析2017-08/2022-07月在作者医院住院治疗的148例SCI患者临床资料.收集SCI患者的性别、年龄、病程、是否肺部感染、吸烟史、体质量指数(body mass index,BMI)、神经损伤平面、美国脊柱损伤协会(American spinal injury association,ASIA)分级和基础肺功能指标[包括潮气量(tidal volume,VT)、用力呼吸肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expir-atory volume in one second,FEV1)与 FVC 比值(forced expiratory volume in one second,FEV1/FVC)、最大通气量(maxi-mum voluntary ventilation,MVV)、最大通气量占预计值百分比(maximal voluntary ventilation/maximal predicted volun-tary ventilation,MVVpred)、呼气肺活量(expiratory vital capacity,EVC)、呼气峰流速(peak expiratory flow,PEF)、用力呼出25％肺活量呼气流速(forced expiratory flow at 25％of FVC exhaled,FEF25)、用力呼出50％肺活量呼气流速(forced expiratory flow at 50％of FVC exhaled,FEF50)、用力呼出 75％肺活量呼气流速(forced expiratory flow at 75％of FVC exhaled,FEF75)]等资料.以改良Barthel指数(modified Barthel index,MBI)为因变量,利用单元及多元线性回归方法筛选SCI患者日常生活能力的独立危险因素.结果 单元及多元线性回归结果显示,SCI患者MBI与VT(β=0.024,P＜0.001),MVVpred(β=0.385,P＜0.001),神经损伤平面 T平面(β=10.613,P=0.009)、L平面(β=12.207,P=0.012)、S 平面(β=27.994,P=0.005),ASIA 分级(CDE)(β=24.550,P＜0.001),性别(女性)(β=9.956,P=0.024)有显著相关性.结论 基础肺功能指标VT、MVVpred与SCI患者日常生活能力密切相关,在治疗过程中应加强心肺康复,最大程度改善患者的日常生活能力.
Correlation Between Basic Lung Function and Daily Living Ability in Patients with Spinal Cord Injury
Objective To explore the correlation between basic lung function and daily living ability in patients with spinal cord injury(SCI),so as to better apply basic lung function indicators for clinical application,guide cardiopulmo-nary rehabilitation training,and provide theoretical basis for improving patients'daily living ability.Methods The clini-cal data of 148 hospitalized SCI patients in the author's hospital from August 2017 to July 2022 were retrospectively ana-lyzed.Gender,age,duration of disease,whether had pulmonary infection,smoking history,body mass index(BMI),neurological level of injury,American spinal injury association(ASIA)classification and basic lung function indexes inclu-ding tidal volume(VT),forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and forced expira-tory volume in one second(FEV1/FVC),maximum voluntary ventilation(MVV),maximal voluntary ventilation/maxi-mal predicted voluntary ventilation(MVVpred),expiratory vital capacity(EVC),peak expiratory flow(PEF),forced expiratory flow at 25％of FVC exhaled(FEF25),forced expiratory flow at 50％of FVC exhaled(FEF50),forced expira-tory flow at 75％of FVC exhaled(FEF75)were collected.Using the modified Barthel index(MBI)as the dependent vari-able,the independent risk factors of daily living ability in patients with SCI were screened by univariate and multivariate linear re-gression.Results The univariate and multivariate linear regression results showed that MBI was significantly correlated with VT(β=0.024,P＜0.001),MVVpred(β=0.385,P＜0.001),nerve injury plane T plane(β=10.613,P=0.009),L plane(β=12.207,P=0.012),S plane(β=27.994,P=0.005),ASIA classification(CDE)(β=24.550,P＜0.001)and gender(famale)(β=9.956,P=0.024)in SCI patients.Conclusion The VT and MVVpred of basic lung function indexes are closely relat-ed to the daily living ability of SCI patients,cardiopulmonary rehabilitation should be strengthened in the course of treat-ment,so as to improve the daily living ability of patients.
Spinal cord injuryBasic lung functionDaily living abilityModified Barthel indexCardiopulmonary rehabilitation
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万方数据
