结缔组织病患者呼吸肌受损对肺通气功能和换气功能的影响(英文)

Effects of respiratory muscles damage on respiratory ventilation and air exchange function of patients with connective tissue disease

目的结缔组织病Connectivetissuedisease(STD)常出现呼吸系统损害,本文旨在探讨CTD患者呼吸肌受损情况对肺通气功能,肺换气功能的影响。方法实验组选自我院CTD患者86例,其中系统性硬皮病(progressivesystemicsclerosis,PSS)21例;系统性红斑狼疮(systemiclupuserythematosus,SLE)30例;皮肌炎(dermatomyositis,DM)35例。对照组20例均为健康自愿者。于入院后治疗前分别测定努力肺活量(FVC)一秒率(FEV1.0/FVC),峰流速(PEF),一氧化碳弥散量(DLOO)最大吸气压(PIMAX),最大呼气压(PEMAX)动脉血氧分压(PaO2),动脉血二氧化碳分压(PaCO2)。结果FVC、DLCO和PaO2CTD各组与对照组比较差异均有显著性(P<0.05或P<0.01);FEV1.0/FVCSLE组和DM组分别为69±8.9,54±13.1与对照组比较86±5.5差异有显著性(P<0.05￣0.01);PEFSLE组和DM组与对照组比较差异有非常显著性(P<0.01￣0.05)。PI-MAX:PSS组、SLE组和DM组分别为79±19.4、65±13.1、48±11.2与对照组且93±16.7比较差异有显著性(P<0.05￣0.01)。PEMAXPSS组、SLE组和DM组分别为37±8.9、35±10.3、23±9.8与对照组54±7.6比较差异有显著性(P<0.05￣0.01)。结论本组实验提示CTD病人存在肺通气功能、肺换气功能障碍同时有呼吸肌受损。

[Objective]Connective tissue disease (CTD) usually coupled with respiratory system dysfunction, such as pleura disease, interstitial lung disease, bronchial disease, respiratory muscle and lung blood vessel disease. There are many reports about lung fibrosis that can induce pulmonary dysfunction, while there are few reports about the relationship between respiratory muscle damage and pulmonary dysfunction. The aim of this study was to investigate the effects of damage to respiratory muscles on respiratory ventilation and air exchange. These can provide reference to the clinical treatment and prognosis relating to the complications of CTD patients. 86 patients in experiment group with CTD in our hospital, which included 21 patients with progressive systemic sclerosis (PSS), 30 patients with systemic lupus erythematosus (SLE), 35 patients with dermatomyositis(DM). 20 persons in control group who are all healthy volunteers in health examination in our hospital. Before treatment all persons were measured forced vital capacity (FVC), the first second ratio (FEV1.0/FVC), peak expiratory flow (PEF), carbon monoxide diffusion (DLCO), the maximal inspiratory pressure (PIMAX), the maximal expiratory pressure (PEMAX), arterial blood pressure of oxygen (PaO2) and arterial blood pressure of Carbon Dioxide (PaCO2), respectively. FVC, DLCO and PaO2 had significant difference between CTD group and control group (P<0.05~0.01); FEV1.0/FVC of SLE and DM groups were (69±8.9) and (54±13.1),compared to control group (86±5.5) had significant difference (P<0.05~0.01); PEF of SLE and DM groups compared to control group had very significantly difference (P<0.01~0.05). PIMAX of PSS, SLE and DM groups were (79±19.4), (65±13.1), (48±11.2) compared to control group (93±16.7) had significant difference (P<0.05~0.01); PEMAX of PSS, SLE and DM groups were (37±8.9), (35±10.3), (23±9.8) compared to control group (54±7.6) had significant difference (P<0.05~0.01). [Conclusions] This experiment showed us CTD patients had ventilation dysfunction, air exchange dysfunction and respiratory muscles damaged, so CTD patients respiratory function disturbance not only related with pulmonary fibrosis but also with respiratory muscles damaged.