临床误诊误治2024，Vol.37Issue(8)：40-45,6.DOI:10.3969/j.issn.1002-3429.2024.08.009
膈肌功能参数与慢性阻塞性肺疾病患者肺功能指标的相关性及其评估病情严重程度的价值
Correlation of Diaphragm Function Parameters with Pulmonary Function Indicators in COPD Patients and Their Value in Evaluation of Disease Severity
摘要
Abstract
Objective To explore the correlation between diaphragm function parameters and pulmonary function in-dicators in patients with chronic obstructive pulmonary disease(COPD)and their value in evaluation of the severity of the con-dition.Methods We selected 100 patients with COPD admitted from September 2021 to November 2023 as the research sub-jects and included them in the COPD group.According to the grading criteria for COPD,it was further divided into mild to moderate group(COPD grades Ⅰ-Ⅱ)and severe group(COPD grades Ⅲ and above).Another 40 healthy volunteers who were age and gender matched with the COPD group were recruited as the control group.All patients underwent diaphragmatic ultrasound examination[diaphragmatic displacement(DD)and thickness during forced breathing(FRC)and calm breathing(TLC)],as well as pulmonary function examination[forced expiratory volume in one second as a percentage of predicted val-ue(FEV1%pred),forced vital capacity as a percentage of predicted,and forced expiratory volume in one second/forced vital capacity(FEV1/FVC)].The differences in diaphragmatic function parameters between the groups were compared,and the correlation between diaphragmatic function parameters and pulmonary function indicators,as well as their value in evaluating the severity of the condition,was analyzed.Results The modified Medical Research Council(mMRC)scale score of the British Medical Research Association in the COPD group was higher than that in the control group,with FEV1%pred,FVC%pred,and FEV1/FVC were all lower than those in the control group(P＜0.05).The DD and thickness during TLC and TLC-FRC phases were the lowest in the severe group,followed by the mild to moderate group and the control group(P＜0.05).The DD during FRC was higher in the severe group and the mild to moderate group than in the control group(P＜0.05),but there was no statistically significant difference between the severe group and the mild to moderate group(P＞0.05).The DD was positively correlated with FEV1/FVC,FEV1%pred,and FVC%pred in COPD patients(P＜0.01),and the thickness of the diaphragm during TLC was positively correlated with FEV1/FVC and FEV1%pred(P＜0.05).The area under the re-ceiver operating characteristic(ROC)curve(AUC)of DD and diaphragm thickness during TLC for assessing the severity of COPD were 0.821 and 0.673,respectively.Conclusion There is a significant correlation between diaphragmatic function parameters by ultrasound and pulmonary function indicators in COPD patients,and ultrasound detection of diaphragmatic func-tion parameters has important reference value for assisting in evaluating the severity of COPD.关键词
肺疾病,慢性阻塞性/超声检查/膈肌移动度/膈肌厚度/第1秒用力呼气容积/用力肺活量/相关性/受试者工作特征曲线Key words
Pulmonary disease,chronic obstructive/Ultrasonography/Diaphragmatic displacement/Diaphragm thickness/Forced expiratory volume in the first second/Forced vital capacity/Correlation/Receiver operating characteristic curve分类
临床医学引用本文复制引用
魏杰,刘皎然,彭龙,周梦,张荣心,刘惠敏,林玉,王天亚,任向影..膈肌功能参数与慢性阻塞性肺疾病患者肺功能指标的相关性及其评估病情严重程度的价值[J].临床误诊误治,2024,37(8):40-45,6.基金项目
河北省医学科学研究课题计划(20231327) （20231327）
