超声对Duchenne肌营养不良儿童膈肌功能的评价  

Ultrasound assessment of diaphragm function in pediatric patients with Duchenne muscular dystrophy

作　　者：张璇[1] 马宇童 苗玉倩 张云[1] 吴士文[2] 党晓楚 陈颖颖 钟兆明 王雪娟[1] 胡淼 孙岩峰 马秀珠 吕发勤[1] 寇海燕 Zhang Xuan;Ma Yutong;Miao Yuqian;Zhang Yun;Wu Shiwen;Dang Xiaochu;Chen Yingying;Zhong Zhaoming;Wang Xuejuan;Hu Miao;Sun Yanfeng;Ma Xiuzhu;Lyu Faqin;Kou Haiyan(Ultrasonic Department,the Third Medical Centre of PLA General Hospital,100039 Beijing,China;Neurology Department,the Third Medical Centre of PLA General Hospital,100039 Beijing,China;Pediatric Department,the Third Medical Centre of PLA General Hospital,100039 Beijing,China)

机构地区：[1]解放军总医院第三医学中心超声科,北京100039 [2]解放军总医院第三医学中心神经内科,北京100039 [3]解放军总医院第三医学中心儿科,北京100039

出　　处：《中华医学超声杂志（电子版）》2023年第10期1068-1073,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：海南国际医学港科技创新平台(ZDKJ2019012);解放军总医院军事医学创新研究项目(CX19025);军委科技委项目(19-163-12-ZT-006-007-04)。

摘　　要：目的探讨超声在评估Duchenne肌营养不良(DMD)儿童膈肌功能中的应用价值。方法收集2021年5月1日至2022年3月1日在解放军总医院第三医学中心临床诊断为DMD的患儿21例,同期纳入同年龄段的健康儿童志愿者21例作为对照组。所有纳入对象均行膈肌超声检查,主要检测指标包括膈肌增厚率(DTF)和膈肌移动度(DE)。对比分析2组间膈肌超声表现及DTF和DE的差异。结果DMD组21例患儿超声均表现为膈肌较正常儿童明显增厚,回声增强,不均匀,呼吸运动减弱。DMD组右侧腋前线DE为(12.0±5.0)mm,低于对照组(19.0±3.3)mm(t=0.207,P<0.001);右侧锁骨中线DE为(11.7±4.1)mm,低于对照组(20.0±5.3)mm(t=0.603,P<0.001)。DMD组的右侧腋前线DTF(38.3±19.4)%低于对照组的(50.6±10.9)%(t=0.013,P=0.015);右侧锁骨中线DTF(32.9±19.0)%低于对照组的(49.7±11.5)%(t=0.079,P=0.002)。结论超声可有效评价DMD患儿膈肌功能,定量测量膈肌DTF、DE有助于DMD患儿病情监测。Objective To evaluate the value of ultrasonography in assessing diaphragm function in children with Duchenne muscular dystrophy(DMD).Methods A total of 21 children with DMD clinically diagnosed at the Third Medical Center of the PLA General Hospital from May 1,2021 to March 1,2022 were collected,and 21 healthy volunteers of the same age group were included as a control group.Diaphragmatic ultrasonography was performed on all subjects,and the main indicators included diaphragmatic thickening rate(DTF)and diaphragmatic mobility(DE).The differences of diaphragm ultrasonography findings,DTF,and DE between the two groups were compared and analyzed.Results Compared with normal children,DMD children showed obvious thickening of the diaphragm,enhanced and uneven echo,and weakened respiratory movement.The right anterior axillary line DE in the DMD group was(12.0±5.0)mm,significantly lower than that of the control group(19.0±3.3)mm(t=0.207,P<0.001).The right midclavicular line DE was(11.7±4.1)mm,also significantly lower than that of the control group(20.0±5.3)mm(t=0.603,P<0.001).The DTF[(38.3±19.4)%]in the DMD group was significantly lower than that of the control group[(50.6±10.9)%](t=0.013,P=0.015).DTF[(32.9±19.0)%]of the right midclavicular line was lower than that of the control group[(49.7±11.5)%](t=0.079,P=0.002).Conclusion Ultrasound can effectively evaluate the diaphragm function in children with DMD,and quantitative measurement of diaphragm DTF and DE is helpful to monitor the condition of children with DMD.

关 键 词：DUCHENNE肌营养不良 超声检查 膈肌 儿童 

分 类 号：R445.1[医药卫生—影像医学与核医学] R723.13[医药卫生—诊断学]