膈肌组织运动峰速度与储备膈肌移动度对老年AECOPD患者膈肌功能的评价  

Diaphragmatic Tissue Peak Velocity and Reserve Diaphragm Mobility on the Evaluation of Diaphragmatic Function in Elderly Patients with AECOPD

作　　者：王晓娜[1] 赵浩天[1] 刘奕 李丽[1] 刘元琳 姚光耀 薛红元[1] Wang Xiaona;Zhao Haotian;Liu Yi;Li Li;Liu Yuanlin;Yao Guangyao;Xue Hongyuan(Department of Ultrasound,Hebei General Hospital,Shijiazhuang 050051,China;Department of Respiratory and Critical Care Medicine,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院超声科,石家庄市050051 [2]河北省人民医院呼吸与危重症医学科,石家庄市050051

出　　处：《中国超声医学杂志》2025年第2期153-156,共4页Chinese Journal of Ultrasound in Medicine

基　　金：河北省医学科学研究课题计划项目(No.20230347、20211264)。

摘　　要：目的探究膈肌组织运动峰速度与储备膈肌移动度超声指标对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者膈肌功能的评价。方法纳入42例老年(≥60岁)AECOPD患者,对照组为30例年龄、性别、体重指数均匹配的健康志愿者。使用超声M模式测量膈肌移动度、深吸气膈肌移动度,并计算储备膈肌移动度;使用组织多普勒成像(TDI)测量膈肌收缩峰速度和舒张峰速度;于肺肝交界区测量肺底胸膜移动度。采用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价诊断效能。结果AECOPD组膈肌收缩峰速度、膈肌舒张峰速度均高于对照组(P<0.05),深吸气膈肌移动度、储备膈肌移动度均低于对照组(P<0.05)。深吸气膈肌移动度、储备膈肌移动度、膈肌收缩峰速度、膈肌舒张峰速度、肺底胸膜移动度对AECOPD的诊断效能AUC分别为0.788、0.839、0.710、0.844、0.514。膈肌移动度与肺底胸膜移动度之间相关性分析显示,在整体72例和30例健康对照组内二者呈中等正相关(r=0.447,P<0.001;r=0.566,P=0.001),在42例AECOPD内二者呈弱正相关(r=0.321,P=0.038)。结论使用储备膈肌移动度指标并结合TDI技术监测膈肌组织运动峰速度对评价老年AECOPD患者膈肌功能的应用价值较高。Objective To explore the value of the movement peak velocity of diaphrag and reserve of diaphragmatic mobility on the diaphragm function in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 42 elderly(≥60 years old)patients with AECOPD were enrolled,and 30 healthy people with matching age,gender and body mass index were enrolled as control group.The diaphragm mobility,deep-inspiration diaphragm mobility,and reserve of diaphragmatic mobility were measured by M-mode ultrasound.Peak systolic velocity of diaphragm and peak diastolic velocity of diaphragm were measured by tissue Doppler imaging(TDI).The pleural mobility of lung base was measured at the lung-liver junction.The receiver operating characteristic(ROC)curve and area under the ROC curve(AUC)were used to evaluate the diagnostic performance.Results The peak systolic velocity of diaphragm and peak diastolic velocity of diaphragm in the AECOPD group were higher than those in control group(P<0.05),the deep-inspiration diaphragm mobility and reserve of diaphragmatic mobility in the AECOPD group were lower than those in control group(P<0.05).The AUC values of deep inspirational diaphragm mobility,reserve diaphragm mobility,diaphragmatic peak velocity,diaphragmatic peak diastolic velocity,and basal pleural mobility were 0.788,0.839,0.710,0.844,and 0.514,respectively.The correlation analysis between diaphragm mobility and pleural mobility showed a moderate positive correlation in the overall 72 cases and 30 control groups(r=0.447,P<0.001;r=0.566,P=0.001),and a weak positive correlation(r=0.321,P=0.038)in 42 cases of AECOPD.Conclusions The use of reserve diaphragm mobility index combined with TDI to monitor the peak velocity of diaphragmatic tissue movement has high application value in evaluating diaphragm function in elderly AECOPD patients.

关 键 词：AECOPD 膈肌超声 组织多普勒 诊断效能 

分 类 号：R563.9[医药卫生—呼吸系统] R445.1[医药卫生—内科学]