临床误诊误治2025，Vol.38Issue(19)：56-62,7.DOI:10.3969/j.issn.1002-3429.2025.19.009
慢性阻塞性肺疾病伴心力衰竭患者膈肌移动度与心肺功能的关联性
Correlation between diaphragmatic mobility and cardiopulmonary function in patients with chronic obstructive pulmonary disease and heart failure
摘要
Abstract
Objective To study the correlation between diaphragmatic mobility and cardiopulmonary function in patients with chronic obstructive pulmonary disease(COPD)complicated by heart failure.Method One hundred patients diagnosed with COPD complicated by heart failure from January 2022 to January 2024 were selected and included in the observation group.Another 100 healthy volunteers who underwent physical examinations during the same period were selected and included in the control group.Both groups of subjects underwent tests for cardiopulmonary function and diaphragmatic mobility.The dyspnea index and pulmonary ventilation conditions of the two groups were evaluated.Taking the control group as a reference,the diaphragmatic mobility of the observation group was evaluated,and the correlation between diaphragmatic mobility and lung function was analyzed.The differences in diaphragm mobility among patients with different grades of heart failure were evaluated,and the correlation between diaphragm mobility and the grade of heart failure was analyzed and confirmed.Result The score of the modified British Medical Research Council dyspnea Questionnaire(mMRC)in the observation group was higher than that in the control group(P<0.05).Compared with the control group,the ventilation indicators of each lung and the diaphragm mobility in the observation group were worse(P<0.05).In severe COPD,the diaphragmatic mobility changes more significantly during calm breathing and forced breathing than in mild and moderate COPD,and the difference in diaphragmatic mobility is smaller(P<0.05).The diaphragmatic mobility and the difference in diaphragmatic mobility during calm breathing and forced breathing in the grade III heart failure group changed more significantly than those in the grade I and grade II heart failure groups(P<0.05).The changes in the above indicators in the grade IV heart failure group further increased,and the difference was more significant than that in the grade III heart failure group(P<0.05).The severity of COPD,the classification of heart failure,the severity of dyspnea,and the ratio of residual volume to total lung capacity were all positively correlated with the diaphragm mobility during calm breathing,and negatively correlated with the diaphragm mobility during forced breathing(P<0.01).Conclusion Abnormal diaphragm function is not only a common pathological manifestation of COPD and heart failure,but may also further exacerbate the deterioration of cardiopulmonary function by affecting mechanisms such as ventilation and cardiac preload.Therefore,evaluating diaphragmatic mobility through ultrasound technology helps to more comprehensively assess the severity and prognosis of COPD patients with heart failure,and provides a basis for individualized treatment.关键词
慢性阻塞性肺疾病/心力衰竭/超声检查/膈肌移动度/心功能/相关性Key words
chronic obstructive pulmonary disease/heart failure/ultrasonography/diaphragmatic mobility/heart function/correlation引用本文复制引用
刘惠敏,何钢,魏杰,刘皎然,周梦,张荣心,林玉..慢性阻塞性肺疾病伴心力衰竭患者膈肌移动度与心肺功能的关联性[J].临床误诊误治,2025,38(19):56-62,7.基金项目
河北省医学科学研究课题计划资助(Medical Science Research Project of Hebei,20231327) （Medical Science Research Project of Hebei,20231327）
