摘要
目的 研究肌萎缩侧索硬化（ALS）患者肺功能及呼吸肌功能的特点。方法 将130例ALS患者按临床起病方式分为球部起病组（36例）和肢体起病组（94例）,并与健康对照组（30例）的肺功能进行比较;并比较球部起病组（35例）和肢体起病组（89例）的呼吸肌功能。结果 与健康对照组比较,球部起病组及肢体起病组肺活量（VC）、用力肺活量（FVC）、第1 s用力呼气量（FEV1）、最大通气量（MVV）、用力呼气高峰流量（PEF）均显著下降（均P〈0.01）。球部起病组及肢体起病组FEV1/FVC均值（〉80%）在正常范围,但球部起病组FEV1/FVC显著低于健康对照组（P〈0.05）。与肢体起病组比较,球部起病组MVV显著降低（P〈0.05）,其他肺功能指标差异无统计学意义（均P〉0.05）。与肢体起病组比较,球部起病组最大吸气压（MIP）、最大呼气压（MEP）显著降低（均P〈0.01）,第0.1 s口腔闭合压（P0.1）差异无统计学意义（P〉0.05）。ALS患者呼吸肌功能异常率（87.90%）显著高于肺功能异常率（52.30%）（χ~2=38.07,P=0.000）。结论 ALS患者肺功能障碍以限制性通气功能障碍为主。球部起病患者呼吸肌功能损害较肢体起病患者更加严重。
Objective To research the characteristics of pulmonary function and respiratory muscle function in patients with amyotrophic lateral sclerosis（ ALS）. Methods One hundred and thirty ALS patients were divided into bulbar onset group（ 36 cases） and limb onset group（ 94 cases） according to clinical onset methods,and compared with the pulmonary function of healthy control group（ 30 cases）; the bulbar onset group（ 35 cases） and the limb onset group（ 89 cases） were compared to respiratory muscle function. Results Compared with healthy control group,vital capacity（ VC）,forced vital capacity（ FVC）,forced expiratory volume in one second（ FEV1）,peak expiratory flow（ PEF）,maximal voluntary ventilation（ MVV） in bulbar onset group and the limb onset group were significantly decreased（ all P 0. 01）. The mean of FEV1 / FVC in bulbar onset group and limb onset group were in the normal range（ 80%）,but the mean of FEV1 / FVC in bulbar onset group was significantly lower than that in healthy control group（ P 0. 05）. Compared with limb onset group,the mean of MVV in bulbar onset group was significantly lower（ P 0. 05）,and the other lung function indexes had no statistical significance（ all P 0. 05）. Compared with limb onset group,the mean of maximal inspiratory pressure（ MIP）,maximal expiratory pressure（ MEP） in bulbar onset group were significantly lower（ all P 0. 01）,and the mean of airway occlusion pressure（ P0. 1） had no statistical significance（ P 0. 05）. The abnormal rate of respiratory muscle function（ 87. 90%） was significantly higher than the abnormal rate of pulmonary function（ 52. 30%） in ALS patients（ χ~2= 38. 07,P = 0. 000）.Conclusions ALS patients with pulmonary dysfunction is given priority to with restrictive ventilatory dysfunction.The harm of respiratory muscle function of bulbar onset patient is more serious than limb onset group.
出处
《临床神经病学杂志》
CAS
北大核心
2016年第4期267-269,共3页
Journal of Clinical Neurology
基金
广东省中医院中医临床评价研究专项(YN2014PJ06)
关键词
肌萎缩侧索硬化
肺功能
呼吸肌功能
amyotrophic lateral sclerosis
pulmonary function
respiratory muscle function
