超声评估慢阻肺患者膈肌移动度与肺功能和BODE指数的关系

Ultrasonographic Assessment of the Diaphragm Mobility in Patients with Chronic Obstructive Pulmonary Disease: Relationships with Pulmonary Function and BODE Index

目的观察慢性阻塞性肺疾病(COPD)患者膈肌移动度变化,评价其与肺功能及BODE指数的关系。方法选取2016年2-6月于上海市东方医院呼吸内科门诊COPD患者25例;健康对照组20例,分别行肺功能检查,并在深吸气时行超声测量膈肌移动度。测量6min步行距离、呼吸困难程度及BODE指数(包括体重指数,气流阻塞程度,呼吸困难指标和运动能力4个变量)。结果 COPD患者膈肌移动度为(4.43±0.94)cm,健康对照组为(5.56±0.72)cm,两组比较差异有统计学意义(t=-4.451,P<0.001)。COPD患者膈肌移动度与第一秒用力呼气容积(r=0.464,P=0.019)呈正相关;与肺气肿呈正相关(肺总容量,r=0.396,P=0.050);与BODE指数呈负相关(r=-0.508,P=0.009)。结论 COPD患者膈肌移动度的下降影响肺功能和BODE指数。

Objective To evaluate alterations of diaphragm mobility in patients with COPD,and to assess the influence of diaphragm mobility on pulmonary function and BODE index in COPD patients.Methods25 COPD patients were recruited from the respiratory outpatient clinic of Shanghai East Hospital of Tongji University and 20 control subjects were included. All subjects were performed with the pulmonary function and ultrasound measurement of diaphragm mobility. The index of diaphragm mobility and pulmonary function, 6 minute walk distance,MMRC,BODE index was assessed.ResultsThe COPD patients had significantly lower diaphragm mobility when compared with the control subjects[（4.43±0.94）cm vs（5.56＋0.72）cm,t=-4.451, P〈0.001）]. The diaphragm mobility presented a positive correlation with FEV1（r=0.464,P=0.019）and TLC （r=0.396,P=0.050）. It was negatively correlated with BODE index（r=-0.508,P=0.009）.ConclusionThe lower of diaphragm mobility contributes to the pulmonary function and BODE index in patients with COPD.