余红缨，董红娟.慢性阻塞性肺病患者呼吸功能及相关神经电生理研究初探[J].中华物理医学与康复杂志,2004,(12):
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| 慢性阻塞性肺病患者呼吸功能及相关神经电生理研究初探 |
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| DOI： |
| 中文关键词: 慢性阻塞性肺病 肺功能 膈神经传导 |
| 英文关键词: Chronic obstructive pulmonary disease Lung function test Phrenic nerve conduction |
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| 中文摘要: |
| 目的初步研究慢性阻塞性肺病（COPD）患者肺功能及其相关神经电生理指标，并探讨二者之间的关系。 方法对50例COPD患者进行肺功能及膈神经运动传导（PNC）检测，以30例因其他原因就诊并无呼吸系统疾患的患者作为对照。肺功能检测主要包括最大通气量（MVV）、一秒率（FEV1/FVC%）和残气容积（RV/TLC%）。PNC检测是在胸锁乳突肌后缘中点用电刺激膈神经，于第7~8肋间和剑突处记录膈肌复合动作电位（dCMAP）。 结果①COPD患者肺功能各项指标均为异常，MVV、FEV1/FVC%和RV/TLC%分别为（49.6±18.8）%、（62.5±16.4）%和（54.1±8.0）%。②2组PNC潜伏期比较，差异无统计学意义；dCMAP波幅比率比较，差异有统计学意义，即COPD患者的dCMAP波幅比率明显减低。 结论COPD患者dCMAP波幅比率减低可能与肺功能减退有一定关系，通过PNC检测可能为肺功能异常者提供膈肌功能障碍的信息。 |
| 英文摘要: |
| Objective To explore the association between the lung function and the related electroneurophysiological parameters in patients with chronic obstructive pulmonary disease (COPD). MethodsFifty COPD patients were studied. The lung function and the phrenic motor nerve conduction (PNC) were examined, respectively. Thirty cases of non-respiratory disorders served as control. The lung function tests included maximal voluntary ventilation (MVV%), forced vital capacity (FVC), force expiratory volume (FEV1) and RV/TLC% (residual volume, RV; total lung capacity, TLC). The phrenic nerve was stimulated electrically at the midpoint of the posterior border of the sternomastoid muscle, and the diaphragmatic compound muscle action potential (dCMAP) was recorded between the 7th and 8th intercostal space and xiphoid process. ResultsThe relative values of MVV%, FVC1/FVC1% and RV/TLC% were 49.6±18.8, 62.5±16.4 and 54.1±8.0, respectively, which was significantly lower than that expected. There was no significant difference with regard to the PNC latency between the patients and the controls. The dCMAP amplitude ratio in the COPD patients was significantly lower than that of the controls, i.e., the dCMAP amplitude decreased in the COPD patients. ConclusionThe decreased dCMAP might be associated with abnormal lung function. The PNC examination would provide valuable information for the evaluation of diaphragmatic dysfunction in those with abnormal lung function. |
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