慢性阻塞性肺疾病患者膈肌形态超声指标与肺功能相关性的临床研究  

Correlation between diaphragmatic ultrasound parameters and pulmonary function in patients with chronic obstructive pulmonary disease

作　　者：邓弼云 潘慧斌[1] 陆敏娇 邹涛[1] Deng Biyun;Pan Huibin;Lu Minjiao;Zou Tao(Department of Ultrasound,The First People's Hospital of Huzhou,Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州市第一人民医院超声科,浙江省313000

出　　处：《中国基层医药》2021年第5期651-655,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医药卫生科技计划项目(2019KY679)。

摘　　要：目的评价慢性阻塞性肺疾病(COPD)患者膈肌形态超声指标与肺功能相关性及其用于COPD诊断的临床价值。方法选择湖州市第一人民医院2019年1月至2020年6月收治的COPD患者80例(COPD组)和同期健康受试者80例(健康对照组)为研究对象。比较两组受试者肺功能指标、膈肌形态超声指标和活动耐力指标差异,统计COPD患者膈肌形态超声指标数值与肺功能指标和活动耐力指标的相关性。结果 COPD组第一秒用力呼气量/用力肺活量(FEV1/FVC)[(56.27±8.98)%]显著低于健康对照组 [(87.42±6.29)%],而残气量/肺总容量(RV/TLC)[(54.81±6.95)%]显著高于健康对照组 [(27.59±3.92)%](t=14.583、17.904,均P<0.05);COPD组6分钟步行试验(6MWT)[(502.36±82.41)m]显著短于健康对照组[(824.59±63.37)m](t=11.726,P<0.05);COPD组平静呼吸膈肌移动度(DMQB)[(1.71±0.45)mm]、深吸气膈肌移动度(DMDB)[(4.03±0.81)m]和膈肌厚度分数(TF)[(117.56±24.83)%]均显著低于健康对照组[(2.24±0.30)mm,(5.36±0.62)mm和(159.60±22.35)%](t=4.736~7.592,均P<0.05);COPD患者DMQB、DMDB和TF均与FEV1/ FVC和6MWT距离呈显著正相关性(r=0.705~0.819,均P<0.05),而与RV/TLC呈显著负相关性(r=-0.774~-0.847,均P<0.05)。结论 COPD患者伴有膈肌移动度和TF下降,且与肺功能及活动耐力指标呈显著相关性,超声检测膈肌形态变化对COPD诊断和病情评估具有一定临床价值。Objective To correlate diaphragmatic ultrasound parameters and pulmonary function in patients with chronic obstructive pulmonary disease(COPD)and its clinical value in the diagnosis of COPD.Methods Eighty patients with COPD who received treatment in The First People's Hospital of Huzhou from January 2019 to June 2020 and 80 healthy subjects who concurrently received health examination were included in this study.Pulmonary function index,diaphragmatic ultrasonic parameters and activity endurance index were compared between COPD group and healthy control group.Diaphragmatic ultrasound parameters in COPD patients were correlated with pulmonary function index and activity endurance index.Results The forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC)ratio in the COPD group was significantly lower than that in the healthy control group[(56.27±8.98)%vs.(87.42±6.29)%,t=14.583,P<0.05].The residual volume/total lung capacity(RV/TLC)ratio in the COPD group was significantly higher than that in the healthy control group[(54.81±6.95)%vs.(27.59±3.92)%,t=17.904,P<0.05].The walking distance in 6-minute walking test(6MWT)in the COPD group was significantly shorter than that in the healthy control group[(502.36±82.41)m vs.(824.59±63.37)m,t=11.726,P<0.05].The diaphragm mobility using quite breathing(DMQB),the diaphragm mobility using deep breathing(DMDB),and diaphragmatic thickening fractions(TF)in the COPD group were(1.71±0.45)mm,(4.03±0.81)m and(117.56±24.83)%,respectively,which were significantly lower than those in the healthy control groups[(2.24±0.30)mm,(5.36±0.62)mm,(159.60±22.35)%,t=4.736-7.592,all P<0.05].DMQB,DMDB and TF in patients with COPD were positively correlated with FEV1/FVC and 6MWT distance(r=0.705-0.819,all P<0.05),but they were negatively correlated with residual volume/total lung capacity(RV/TLC)ratio(r=-0.774 to-0.847,all P<0.05).Conclusions DMQB,DMDB and TF decrease in COPD patients,and their values are correlated with pulmonary function and activity tolerance index.Ultrasound

关 键 词：肺疾病 慢性阻塞性 超声检查 膈肌 呼吸功能试验 身体耐力 相关性 诊断 评估 

分 类 号：R563.9[医药卫生—呼吸系统]