脊髓损伤患者基础肺功能与日常生活能力的相关性研究  

Correlation Between Basic Lung Function and Daily Living Ability in Patients with Spinal Cord Injury

作　　者：林小东 吴相波 郭颖 何霞 薛白洁 胡旭 许招娣 孙玮 牛丹 孙晓龙 LIN Xiaodong;WU Xiangbo;GUO Ying;HE Xia;XUE Baijie;HU Xu;XU Zhaodi;SUN Wei;NIU Dan;SUN Xiaolong(Department of Rehabilitation Medicine,the First Affiliated Hospital of Air Force Military Medical University(Xijing Hospital),Xian Shaanxi 710032,China)

机构地区：[1]空军军医大学第一附属医院(西京医院)康复医学科,陕西西安710032

出　　处：《联勤军事医学》2024年第7期568-572,共5页Military Medicine of Joint Logistics

基　　金：国家自然科学基金面上项目(82272591)。

摘　　要：目的 探究脊髓损伤(spinal cord injury,SCI)患者基础肺功能与日常生活能力的相关性,为临床更好地应用基础肺功能指标指导心肺康复训练、提高患者日常生活能力提供理论依据。方法 回顾性分析2017-08/2022-07月在作者医院住院治疗的148例SCI患者临床资料。收集SCI患者的性别、年龄、病程、是否肺部感染、吸烟史、体质量指数(body mass index,BMI)、神经损伤平面、美国脊柱损伤协会(American spinal injury association,ASIA)分级和基础肺功能指标[包括潮气量(tidal volume,VT)、用力呼吸肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))与FVC比值(forced expiratory volume in one second,FEV_(1)/FVC)、最大通气量(maximum voluntary ventilation,MVV)、最大通气量占预计值百分比(maximal voluntary ventilation/maximal predicted voluntary ventilation,MVVpred)、呼气肺活量(expiratory vital capacity,EVC)、呼气峰流速(peak expiratory flow,PEF)、用力呼出25%肺活量呼气流速(forced expiratory flow at 25%of FVC exhaled,FEF_(25))、用力呼出50%肺活量呼气流速(forced expiratory flow at 50%of FVC exhaled,FEF_(50))、用力呼出75%肺活量呼气流速(forced expiratory flow at 75%of FVC exhaled,FEF_(75))]等资料。以改良Barthel指数(modified Barthel index,MBI)为因变量,利用单元及多元线性回归方法筛选SCI患者日常生活能力的独立危险因素。结果 单元及多元线性回归结果显示,SCI患者MBI与VT(β=0.024,P<0.001),MVVpred(β=0.385,P<0.001),神经损伤平面T平面(β=10.613,P=0.009)、L平面(β=12.207,P=0.012)、S平面(β=27.994,P=0.005),ASIA分级(CDE)(β=24.550,P<0.001),性别(女性)(β=9.956,P=0.024)有显著相关性。结论 基础肺功能指标VT、MVVpred与SCI患者日常生活能力密切相关,在治疗过程中应加强心肺康复,最大程度改善患者的日常生活能力。Objective To explore the correlation between basic lung function and daily living ability in patients with spinal cord injury(SCI),so as to better apply basic lung function indicators for clinical application,guide cardiopulmonary rehabilitation training,and provide theoretical basis for improving patients′ daily living ability.Methods The clinical data of 148 hospitalized SCI patients in the author′s hospital from August 2017 to July 2022 were retrospectively analyzed.Gender,age,duration of disease,whether had pulmonary infection,smoking history,body mass index(BMI),neurological level of injury,American spinal injury association(ASIA) classification and basic lung function indexes including tidal volume(VT),forced vital capacity(FVC),forced expiratory volume in one second(FEV_1) and forced expiratory volume in one second(FEV_1/FVC),maximum voluntary ventilation(MVV),maximal voluntary ventilation/maximal predicted voluntary ventilation(MVVpred),expiratory vital capacity(EVC),peak expiratory flow(PEF),forced expiratory flow at 25% of FVC exhaled(FEF_(25)),forced expiratory flow at 50% of FVC exhaled(FEF_(50)),forced expiratory flow at 75% of FVC exhaled(FEF_(75)) were collected.Using the modified Barthel index(MBI) as the dependent variable,the independent risk factors of daily living ability in patients with SCI were screened by univariate and multivariate linear regression.Results The univariate and multivariate linear regression results showed that MBI was significantly correlated with VT(β=0.024,P<0.001),MVVpred(β=0.385,P<0.001),nerve injury plane T plane(β=10.613,P=0.009),L plane(β=12.207,P=0.012),S plane(β=27.994,P=0.005),ASIA classification(CDE)(β=24.550,P<0.001) and gender(famale)(β=9.956,P=0.024) in SCI patients.Conclusion The VT and MVVpred of basic lung function indexes are closely related to the daily living ability of SCI patients,cardiopulmonary rehabilitation should be strengthened in the course of treatment,so as to improve the daily living ability of patients.

关 键 词：脊髓损伤 基础肺功能 日常生活能力 改良BARTHEL指数 心肺康复 

分 类 号：R730.9[医药卫生—肿瘤] R493[医药卫生—临床医学]