颈髓损伤晚期患者肺功能下降与其部位及程度的相关性

Correlation between pulmonary function descent and its site as well as degree in patients with late cervical spinal cord injury

目的:探讨颈髓损伤晚期患者肺功能的改变及损伤部位对肺功能的影响。方法:对40例颈髓损伤晚期患者根据不同损伤部位分为C3～5组与C6～8组,又根据不同损伤程度分为完全损伤组和不完全性损伤组,测定每例患者最大肺活量(VCMAX)、时间肺活量(forcedvitalcapacity,FVC)、第1秒最大呼气量(forcedexpiratoryvolumein1s,FEV1)、呼气高峰流量(peakexpiratoryflow,PEF)、根据美国脊柱损伤学会(ASIA)评分标准对每例患者进行脊髓损伤评分。结果:40例颈髓损伤晚期患者肺功能VCMAX%=51.83±17.65,FVC%=52.08±18.51,FEV1%=56.99±18.45,PEF%=59.55±20.26皆显示降低,ASIA评分与VCMAX,FVC,FEV1,PEF成正相关;C3～5组ASIA评分,VCMAX%,FVC%,FEV1%,PEF%与C6-8组比较差异均无显著性意义;C3～5组:ASIA评分与VCMAX%%,FVC%,FEV1%成正相关(P<0.05),与PEF无相关性(P>0.05);C6～8组:ASIA评分与VCMAX%,FVC%,FEV1%,PEF%无相关性(P>0.05);C3-5组内完全损伤组与不完全损伤组比较,ASIA评分,VCMAX%,FVC%,FEV1%,PEF%差异均无显著性意义(P>0.05);C6～8组内完全损伤组与不完全损伤组ASIA评分,FEV1%差异无显著性意义(P>0.05);VCMAX%,FVC%,PEF%差异有显著性意义(t=2.677,2.393,2.177,P<0.05)。结论:颈髓损伤晚期患者肺功能皆下降。

AIM:To explore the changes of pulmonary function and effects of injured sites on it in patients with late cervical spinal cord injury. METHODS:According to different injured sites,40 patients with late cervical spinal cord injury were divided into C3-5 and C6-8 group.Moreover,the patients were divided into complete injury and incomplete injury group according to different injured degrees.Maximum of vital capacity(VCMAX),forced vital capacity(FVC),forced expiratory volume in 1 s(FEV1) and peak expiratory flow(PEF) were tested on each patient,and the spinal cord injury was assessed on each patient with the criterion of American Spinal Injury Association(ASIA). RESULTS:The level of pulmonary function in 40 patients with late cervical spinal injury showed lower(VCMAX%=51.83±17.65,FVC% =52.08±18.51,FEV1%=56.99±18.45,PEF%=59.55±20.26),and ASIA score was positively correlated with VCMAX,FVC,FEV1 and PEF.ASIA score,VCMAX%,FVC%,FEV1% and PEF% in C3-5 group were no significantly different from those in C6-8 group.In C3-5 group,ASIA score was positively correlated with VCMAX%,FVC% and FEV1%(P< 0.05),but was no correlation with PEF(P >05).In C6-8 group,ASIA score had no correlation with VCMAX%,FVC%,FEV1% and PEF% (P >0.05).The comparison between complete injury and incomplete injury group of C3-5 group showed that ASIA score,VCMAX%,FVC%,FEV1% and PEF% had no significant difference(P >0.05);in C6-8 group,ASIA score and FEV1%had no significant difference(P >0.05),but VCMAX%,FVC% and PEF% had significant difference(t=2.677,2.393,2.177,P >0.05). CONCLUSION:Pulmonary function descent in patients with late cervical spinal cord injury is not correlated to the degree and injured sites,and different injured degrees in the same injured site result in different effects on pulmonary function.