慢性阻塞性肺疾病急性加重期患者骨骼肌功能与其疾病严重程度的关系探讨

Relationship between skeletal muscle dysfunction and disease severity in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺(COPD)疾病急性加重期患者骨骼肌功能(SMD)与疾病严重程度的之间关系。方法选取2018年2月—2019年10月在永城市人民医院接受治疗的急性加重期COPD患者为研究对象,根据患者肺功能等级分为4组,Ⅰ级36例,Ⅱ级38例,Ⅲ级45例,Ⅳ级31例,合计共150例,检测四组患者股四头肌最大主动收缩力(QMVC)、握力(HGS)、6min步程、最大吸气压力(MIP)与吸气流速峰值(PIF),并对其进行比较,分析COPD患者肺功能等级与SMD之间的相关性。结果COPD分级越高的患者QMVC、HGS、6min步程、MIP与PIF各项指标均越低,且除6min步程Ⅰ级与Ⅱ级差异无统计学意义(P>0.05),其他各组间对比差异有统计学意义(P<0.05),COPD患者肺功能等级与骨骼肌功能障碍呈负相关。结论COPD急性加重期患者骨骼肌功能障碍与疾病严重程度密切相关,且随着病情的进展,骨骼肌功能下降越严重。

Objective To explore the relationship between skeletal muscle dysfunction(SMD)and disease severity in patients with acute exacerbation of chronic obstructive pulmonary(COPD)disease.Methods The patients with acute exacerbation of COPD who were treated in our hospital from February 2018 to October 2019 were selected as the research subjects,and the patients were divided into four groups according to the lung function grades,including 36 cases of gradeⅠ,38 cases of gradeⅡ,45 cases of gradeⅢand 31 cases of gradeⅣ,with 150 cases in total.The quadriceps maximal volitional contraction(QMVC),grip strength(HGS),6-min step distance,maximal inspiratory pressure(MIP)and peak inspiratory flow(PIF)were detected and compared among the four groups of patients,and the correlation between lung function grading and SMD was analyzed among patients with COPD.Results The higher the COPD grade,the lower the QMVC,HGS,6-min step distance,MIP and PIF,and there was no significant difference in the 6-min step distance between gradeⅠand gradeⅡ(P>0.05),and there were significant differences in the other indexes among the groups(P<0.05).The lung function grading of patients with COPD was negatively correlated with skeletal muscle dysfunction.Conclusion The skeletal muscle dysfunction of patients with acute exacerbation of COPD is closely related to the severity of the disease,and as the disease progresses,the skeletal muscle function declines more severely.