慢性阻塞性肺疾病患者膈肌厚度分数与活动耐力和呼吸困难的相关性

Correlation between diaphragm thickness fraction and activity tolerance and dyspnea in patients with COPD

目的:观察慢性阻塞性肺疾病(COPD)患者膈肌厚度分数和活动耐力及其变化,评价其与呼吸困难的关系。方法:选取COPD患者为COPD组(74例),来院健康体检者为对照组(74例),分别比较两组肺功能检查、膈肌厚度和膈肌厚度分数(TF),比较COPD组不同膈肌肌部厚度患者肺功能,计算功能残气(FRC)至肺总量(TLC)时相膈肌厚度的变化,分析COPD组患者膈肌厚度、TF和肺功能的相关性。结果:两组患者一秒用力呼气容积(FEV1%)、一秒用力呼吸容积占用力肺活量比值(FEV1/FVC)、残气量(RV)、TLC含量差异有统计学意义(P<0.05),COPD组患者FEV1%、FEV1/FVC含量显著低于对照组,RV、TLC含量显著高于对照组。COPD组膈肌厚度、TF显著低于对照组。COPD组不同膈肌肌部厚度患者肺功能比较,FEV1%、FEV1/FVC、RV、TLC含量差异有统计学意义(P<0.05),其中<3 mm组FEV1%、FEV1/FVC显著高于3~6 mm组和>6 mm组,RV、TLC含量显著低于3~6 mm组和>6 mm组。COPD组患者膈肌厚度、TF和肺功能相关性分析,膈肌厚度与FEV1%、FEV1/FVC呈正相关,与RV、TLC呈负相关;TF与FEV1%、FEV1/FVC呈正相关,与RV、TLC呈负相关。结论:COPD患者膈肌结构的变化和气流受限、异常肺通气之间密切相关,同时膈肌厚度分数的测量对评价患者呼吸动力学状态有重要临床意义。

Objective To observe the changes of diaphragm thickness fraction,activity tolerance and their relationship with dyspnea in patients with chronic obstructive pulmonary disease(COPD).Method 74 patients with COPD in our hospital were selected as COPD group and 74 patients as control group.Comparison of pulmonary function in patients with different diaphragmatic muscle thickness in CODP group,the changes of diaphragm thickness from FRC to TLC were calculated and the correlation between TF and lung function was analyzed.Results There were significant differences in the contents of FEV1%,FEV1/FVC,RV,TLC between the two groups(P<0.05),the contents of FEV1%and FEV1/FVC in COPD group were significantly lower than those in control group,and the contents of RV and TLC were significantly higher than those in control group.The diaphragm thickness and TF expression level in COPD group were significantly lower than those in control group.There was significant difference in the contents of FEV1%,FEV1/FVC,RV and TLC in patients with different diaphragm thickness in COPD group(P<0.05).Specifically the contents of FEV1%,FEV1/FVC in<3 mm group were significantly higher those in 3~6 mm group and>6 mm group.and the contents of RV and TLC were significantly lower than those in 3~6 mm group and>6 mm group.The correlation analysis of diaphragm thickness,TF and pulmonary function in COPD group showed that diaphragm thickness was positively correlated with FEV1%,FEV1/FVC,and negatively correlated with RV and TLC;TF was positively correlated with FEV1%,FEV1/FVC,and negatively correlated with RV and TLC.Conclusion The changes of diaphragm structure in patients with COPD are closely related to airflow restriction and abnormal lung ventilation.At the same time,the measurement of diaphragm thickness fraction is of great clinical significance in evaluating the respiratory dynamics of patients.