慢性阻塞性肺病患者呼吸功能及相关神经电生理研究初探  

Evaluation of pulmonary function and neurophysiological change in patient with chronic obstructive pulmonary disease

作　　者：余红缨[1] 董红娟[2] 

机构地区：[1]武汉大学人民医院呼吸内科,重庆400014 [2]武汉大学人民医院神经科,重庆400014

出　　处：《中华物理医学与康复杂志》2004年第12期737-739,共3页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的　初步研究慢性阻塞性肺病 (COPD)患者肺功能及其相关神经电生理指标 ,并探讨二者之间的关系。方法　对 5 0例COPD患者进行肺功能及膈神经运动传导 (PNC)检测 ,以 3 0例因其他原因就诊并无呼吸系统疾患的患者作为对照。肺功能检测主要包括最大通气量 (MVV)、一秒率 (FEV1/FVC % )和残气容积 (RV/TLC % )。PNC检测是在胸锁乳突肌后缘中点用电刺激膈神经 ,于第 7～ 8肋间和剑突处记录膈肌复合动作电位(dCMAP)。结果　①COPD患者肺功能各项指标均为异常 ,MVV、FEV1/FVC %和RV/TLC %分别为(4 9.6± 18.8) %、(62 .5± 16.4) %和 (5 4.1± 8.0 ) %。② 2组PNC潜伏期比较 ,差异无统计学意义 ;dCMAP波幅比率比较 ,差异有统计学意义 ,即COPD患者的dCMAP波幅比率明显减低。结论　COPD患者dCMAP波幅比率减低可能与肺功能减退有一定关系 ,通过PNC检测可能为肺功能异常者提供膈肌功能障碍的信息。Objective To explore the association between the lung function and the related electroneurophysiological parameters in patients with chronic obstructive pulmonary disease (COPD). Methods Fifty COPD patients were studied. The lung function and the phrenic motor nerve conduction (PNC) were examined, respectively. Thirty cases of non respiratory disorders served as control. The lung function tests included maximal voluntary ventilation (MVV%), forced vital capacity (FVC), force expiratory volume (FEV 1) and RV/TLC% (residual volume, RV; total lung capacity, TLC). The phrenic nerve was stimulated electrically at the midpoint of the posterior border of the sternomastoid muscle, and the diaphragmatic compound muscle action potential (dCMAP) was recorded between the 7th and 8th intercostal space and xiphoid process. Results The relative values of MVV%, FVC 1/FVC 1% and RV/TLC% were 49.6±18.8, 62.5±16.4 and 54.1±8.0, respectively, which was significantly lower than that expected. There was no significant difference with regard to the PNC latency between the patients and the controls. The dCMAP amplitude ratio in the COPD patients was significantly lower than that of the controls, i.e., the dCMAP amplitude decreased in the COPD patients. Conclusion The decreased dCMAP might be associated with abnormal lung function. The PNC examination would provide valuable information for the evaluation of diaphragmatic dysfunction in those with abnormal lung function.

关 键 词：COPD患者 肺功能 神经电生理 慢性阻塞性肺病 波幅 膈神经 呼吸功能 中点 初探 结论 

分 类 号：R563.9[医药卫生—呼吸系统]