膈肌功能参数与慢性阻塞性肺疾病患者肺功能指标的相关性及其评估病情严重程度的价值
Correlation of Diaphragm Function Parameters with Pulmonary Function Indicators in COPD Patients and Their Value in Evaluation of Disease Severity
魏杰 1刘皎然 1彭龙 1周梦 1张荣心 1刘惠敏 2林玉 1王天亚 1任向影3
作者信息
- 1. 050000 石家庄,联勤保障部队第九八〇医院超声诊断科
- 2. 050000 石家庄,联勤保障部队第九八〇医院呼吸与危重症科
- 3. 065700 河北廊坊,廊坊市第四人民医院内科
- 折叠
摘要
目的 探究膈肌功能参数与慢性阻塞性肺疾病(COPD)患者肺功能指标的相关性及其评估病情严重程度的价值.方法 选取2021 年9 月—2023 年11 月收治的100 例COPD为研究对象,纳入COPD组;再依据COPD分级标准分为轻-中度组(COPD Ⅰ～Ⅱ级)、重度组(COPD Ⅲ级及以上).同时招募与COPD组年龄、性别相匹配的健康志愿者40 例作为对照组.均进行膈肌超声检查[用力呼吸(TLC)、平静呼吸(FRC)时相膈肌移动度及膈肌厚度]以及肺功能检查[第 1 秒用力呼气容积占预计值百分比(FEV1%pred)、用力肺活量占预计值百分比(FVC%pred)、FEV1/FVC],比较各组间膈肌功能参数差异,分析膈肌功能参数与肺功能指标的相关性及评估病情严重程度的价值.结果 COPD组改良版英国医学研究会呼吸困难量表评分高于对照组,FEV1%pred、FVC%pred、FEV1/FVC均低于对照组(P＜0.05).TLC、TLC-FRC时相的膈肌移动度和膈肌厚度,重度组低于轻-中度组低于对照组(P＜0.05);FRC时相膈肌移动度,重度组和轻-中度组均高于对照组(P＜0.05),但重度组与轻-中度组比较差异无统计学意义(P＞0.05).膈肌移动度与COPD患者FEV1/FVC、FEV1%pred、FVC%pred呈正相关(P＜0.01).TLC时相膈肌厚度与FEV1/FVC、FEV1%pred呈正相关(P＜0.05).TLC时相膈肌移动度及膈肌厚度评估COPD病情严重程度的曲线下面积分别为0.821 及0.673.结论 COPD患者超声膈肌功能参数与肺功能指标具有显著相关性,超声检测膈肌功能参数对辅助评估COPD病情严重程度具有重要参考价值.
Abstract
Objective To explore the correlation between diaphragm function parameters and pulmonary function in-dicators in patients with chronic obstructive pulmonary disease(COPD)and their value in evaluation of the severity of the con-dition.Methods We selected 100 patients with COPD admitted from September 2021 to November 2023 as the research sub-jects and included them in the COPD group.According to the grading criteria for COPD,it was further divided into mild to moderate group(COPD grades Ⅰ-Ⅱ)and severe group(COPD grades Ⅲ and above).Another 40 healthy volunteers who were age and gender matched with the COPD group were recruited as the control group.All patients underwent diaphragmatic ultrasound examination[diaphragmatic displacement(DD)and thickness during forced breathing(FRC)and calm breathing(TLC)],as well as pulmonary function examination[forced expiratory volume in one second as a percentage of predicted val-ue(FEV1%pred),forced vital capacity as a percentage of predicted,and forced expiratory volume in one second/forced vital capacity(FEV1/FVC)].The differences in diaphragmatic function parameters between the groups were compared,and the correlation between diaphragmatic function parameters and pulmonary function indicators,as well as their value in evaluating the severity of the condition,was analyzed.Results The modified Medical Research Council(mMRC)scale score of the British Medical Research Association in the COPD group was higher than that in the control group,with FEV1%pred,FVC%pred,and FEV1/FVC were all lower than those in the control group(P＜0.05).The DD and thickness during TLC and TLC-FRC phases were the lowest in the severe group,followed by the mild to moderate group and the control group(P＜0.05).The DD during FRC was higher in the severe group and the mild to moderate group than in the control group(P＜0.05),but there was no statistically significant difference between the severe group and the mild to moderate group(P＞0.05).The DD was positively correlated with FEV1/FVC,FEV1%pred,and FVC%pred in COPD patients(P＜0.01),and the thickness of the diaphragm during TLC was positively correlated with FEV1/FVC and FEV1%pred(P＜0.05).The area under the re-ceiver operating characteristic(ROC)curve(AUC)of DD and diaphragm thickness during TLC for assessing the severity of COPD were 0.821 and 0.673,respectively.Conclusion There is a significant correlation between diaphragmatic function parameters by ultrasound and pulmonary function indicators in COPD patients,and ultrasound detection of diaphragmatic func-tion parameters has important reference value for assisting in evaluating the severity of COPD.
关键词
肺疾病,慢性阻塞性/超声检查/膈肌移动度/膈肌厚度/第1秒用力呼气容积/用力肺活量/相关性/受试者工作特征曲线Key words
Pulmonary disease,chronic obstructive/Ultrasonography/Diaphragmatic displacement/Diaphragm thickness/Forced expiratory volume in the first second/Forced vital capacity/Correlation/Receiver operating characteristic curve引用本文复制引用
基金项目
河北省医学科学研究项目(20231327)
出版年
2024
国家科技期刊平台
NSTL
万方数据