慢性阻塞性肺病患者膈神经传导测定  

DETERMINATION OF PHRENIC MOTOR NERVE CONDUCTION IN PATIENT WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

作　　者：赵红东[1] 唐冰[1] 姜建东[2] 

机构地区：[1]南京医科大学附属南京市第一医院神经内科,邮政编码210006 [2]南京医科大学附属南京市第一医院

出　　处：《现代电生理学杂志》2006年第3期137-139,共3页Journal of Modern Electrophysiology

摘　　要：目的:初步研究慢性阻塞性肺病患者(COPD)肺功能及膈神经传导(PNC),并探讨二者之间的关系。方法:对22例患者进行肺功能及膈神经运动传导。以14例因其它原因就诊并无呼吸系统疾患的患者作为对照。肺功能检测主要指标包括:第一秒用力肺活量(FEV1),第一秒用力肺活量与预计值的百分比(FEV1%)、用力肺活量(FVC)、一秒率(FEV1/FVC%)。PNC检测方法是在胸锁乳突肌后缘中点用力电刺激膈神经,于过剑突的截面与腋前线的连线记录膈肌复合动作电位(dCMAP),测量其波幅及潜伏期。结果:1、COPD患者肺功能各项指标FEV1、FEV1%、FVC、FEV1/FVC%分别为0.68±0.54、27.8±18.6、1.44±0.74、50.2±19.6,均为异常,与对照组相比有显著性差异。2、两组PNC潜伏期比较,差异无统计学意义;dCMAP波幅比较,差异有统计学意义。即COPD患者的膈神经传导波幅明显减低。结论:COPD患者膈神经动作电位波幅降低,可能与肺功能减退、膈肌疲劳有一定关系,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。Objectives： To explore the relation between the lung function and the phrenic motor nerve conduction（PNC） in patients with chronic obstructive pulmonary disease（COPD）. Methods：Twentytwo patients with COPD were studied. The lung function and the PNC were examined respectively. Fourteen cases without respiratory disorders served as control. The lung function tests include forced vital capacity （FVC） ,forced expiratory volume in first second （FEV1） and FEV1%. The phrenic nerve was simulated electrically at the midpoint of the posterioi border of the sternocleidomastoid muscle, and the diaphragmatic compound muscle action potential（dCMAP） was recorded at the point of intersection which through the xiphoid process and the axillary anterior line. Results：The relative index of FEV1 ,FEV1% ,FVC and FEV1/ FEV% were 0.68 ± 0.54,27.8 ± 18.6,1.44±0.74,50.2 ±19.6 respectively, Which was significantly lower than that expected. There was no significantly defference with regard to the PNC latency between the patients and the controls. The dCMAP amplitude in the patients with COPD was significantly lower than that of the controls,i, e. ,the dCMAP amplitude decreased in the patients with COPD. Conclnsions：The decreased dCMAP might would provide lung function. be relative with abnomal lung function diaphragmatic dysfunction. The PNC examination valuble information for the evaluation of diaphragmatic dysfunction in patients with abnomal lung function.

关 键 词：慢性阻塞性肺病 肺功能 隔神经传导 

分 类 号：R563.9[医药卫生—呼吸系统]