体表电极代替多导食道电极测定慢性阻塞性肺疾病患者呼吸中枢驱动的可行性

Feasibility of body surface electrodes instead of multipair esophageal electrodes for assessment of neural respiratory drive in COPD patients

目的探讨体表电极代替多导食道电极测定慢性阻塞性肺疾病(慢阻肺)患者呼吸中枢驱动的可行性。方法研究对象为呼吸科门诊29例稳定期中重度慢阻肺患者,均为男性,平均年龄(65.6±7.2)岁。采用体表电极和多导食道电极同时记录患者吸入支气管舒张剂前后静息状态和等二氧化碳高通气(MIV)时膈肌肌电和肺通气量的变化,比较两种方法测定的呼吸中枢驱动的差异。采用重复测量数据的方差分析,两两比较用最小LSD检验,相关分析采用Pearson检验。结果吸入支气管舒张剂后,患者静息和MIV时的肺通气量增加,体表电极和多导食道电极测定的呼吸中枢驱动均同步降低,呈显著相关(r=0.660,P<0.01)。结论采取措施尽可能减少体表电极干扰的情况下,体表电极可以代替多导食道电极测定慢阻肺患者的呼吸中枢驱动。

Objective To analyze the feasibility of body surface electrodes instead of multipair esophageal electrodes for the evaluation of neural respiratory drive in patients with COPD.Methods Diaphragm electromyogram(EMG)from body surface electrodes and multipair esophageal electrodes,was recorded in 29 patients with stable COPD recruited from outpatient clinic.Changes of neural respiratory drive of two kinds of electrodes during resting and maximal isocapnic ventilation(MIV)were observed before and after inhalation of bronchodilators.Results Ventilation significantly improved,RMS-sur and RMS-eso significantly decreased after the inhalation of bronchodilators during resting and MIV.RMS-sur and RMS-eso were significantly correlated(r=0.660,P<0.01).Conclusion EMG from the surface electrodes may be a useful and noninvasive technique to evaluate neural respiratory drive in patients with COPD.