摘要
目的应用高频超声评估慢性阻塞性肺疾病(COPD)患者是否合并膈肌形态及功能的变化,为COPD患者膈肌功能障碍提供影像学依据。方法收集2020年6月~2021年2月确诊的76例COPD患者为COPD组,选取同时期门诊50例健康体检人员为对照组;肺功能分级根据慢性阻塞性肺疾病全球倡议(GOLD)分级标准,将COPD组分GOLD 1级15例、GOLD 2级21例、GOLD 3级19例,GOLD 4级21例;根据是否合并呼吸衰竭将COPD组分为呼吸衰竭组28例和无呼吸衰竭组48例。应用高频超声测量受试者平静吸气末膈肌厚度(TDI)、平静呼气末膈肌厚度(TDE)、用力吸气末膈肌厚度(TDImax)及用力呼气末膈肌厚度(TDEmax),计算膈肌增厚分数(TF)。对比COPD组和对照组、不同气流受限严重程度分组间以及是否合并呼吸衰竭分组之间的膈肌厚度及增厚分数的差异。结果COPD组与对照组相比:两组TDI比较,差异无统计学意义(P>0.05);COPD组TDImax及TF均低于对照组,TDE、TDEmax均高于对照组,差异均有统计学意义(P<0.05)。不同气流受限严重程度分组及对照组的比较:五组间TDI比较,差异无统计学意义(P>0.05);五组间TDImax、TDE、TDEmax和TF比较,差异均有统计学意义(P<0.05),随气流受限程度加重,TDImax、TF逐渐下降,而GLOD 3组和GLOD 4组TDE、TDEmax呈上升趋势。是否合并呼吸衰竭组与对照组比较:三组间TDI比较,差异无统计学意义(P>0.05);三组间TDImax、TDE、TDEmax和TF比较,差异均有统计学意义(P<0.05),与无呼吸衰竭组比较.呼吸衰竭组TDImax、TF下降,而TDE、TDEmax上升。结论COPD患者多合并膈肌结构及功能障碍,且随着病情加重,膈肌功能呈下降趋势,高频超声可有效监测COPD患者的膈肌结构及功能的变化。
Objective To evaluate the diaphragmatic morphology and function in patients with chronic obstructive pulmonary disease(COPD) by high frequency ultrasound.Methods Seventy-six patients with COPD diagnosed from June 2020 to February 2021 were collected as a COPD group, and 50 healthy persons undergoing healthy checkup during the same period were selected as a control group.According to the global initiative for chronic obstructive lung disease(GOLD),the COPD group was subdivided into four groups, including GOLD grade 1(15 cases),GOLD grade 2(21 cases),GOLD grade 3(19 cases),and GOLD grade 4(21 cases).According to the presence of respiratory failure, the COPD group was subdivided into a respiratory failure group(28 cases) and a non-respiratory failure group(48 cases).The thickness of diaphragm on inspiration(TDI),thickness of diaphragm on expiration(TDE),thickness of diaphragm on maximum inspiration(TDImax) and thickness of diaphragm on maximum expiration(TDEmax) were measured by high-frequency ultrasound, and the diaphragmatic thickening fraction(TF) was calculated.The diaphragm thickness and TF were compared between the different groups.Results There was no significant difference in TDI between the COPD group and control group(P>0.05).TDImax and TF in the COPD group were lower than those in the control group, and TDE and TDEmax were higher than those in the control group.The differences were statistically significant(P<0.05).There was no significant difference in TDI among the control group, GOLD grade 1,GOLD grade 2,GOLD grade 3,and GOLD grade 4(P>0.05),but there were significant differences in TDImax, TDE,TDEmax and TF among the five groups(P<0.05).With the aggravation of airflow limitation, TDImax and TF were gradually decreased, while TDE and TDEmax showed an upward trend in GOLD grade 3 and GOLD grade 4.There was no significant difference in TDI among the respiratory failure group, non-respiratory group and control group(P>0.05),but there were significant differences in TDImax, TDE,TDEmax and TF(P<0.05).Compar
作者
南淑良
温红侠
穆靓
刘莉
亢春苗
王肖潇
Nan Shuliang;Wen Hongxia;Mu Liang;Liu li;Kang Chunmiao;Wang Xiaoxiao(Ultrasound Medical Diagnosis Center,Shaanxi Povincial People's Hospital,Xi'an 710068;Department of Respiratory and Critical Care,Shaanxi Povincial People's Hospital,Xi'an 710068;Department of Emergency Medicine,Shaanxi Povincial People's Hospital,Xi'an 710068)
出处
《国际老年医学杂志》
2022年第6期685-689,共5页
International Journal of Geriatrics
基金
陕西省重点研发计划项目(2020SF-110,2018SF-180)
陕西省人民医院科技发展孵化基金项目(2021YJY-10)。
关键词
高频超声
慢性阻塞性肺疾病
膈肌
膈肌厚度
膈肌增厚分数
High frequency ultrasound
Chronic obstructive pulmonary disease
Diaphragm
Diaphragm thickness
Diaphragmatic thickening fraction
