肺部超声波评估稳定型慢性阻塞性肺病患者的肺过度充气:一种有效的诊断工具

IF 2.8 3区 医学 Q1 Medicine
Yongjian Chen, Jingyun Li, Zhixing Zhu, Guorong Lyu
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引用次数: 0

摘要

目的:通过肺超声评分(LUS)评估慢性阻塞性肺疾病(COPD)稳定期患者的肺过度充气(LH)程度,并评估其价值:我们对福建医科大学附属第二医院招募的149名稳定期慢性阻塞性肺疾病患者和100名健康对照者进行了研究。测量胸膜滑动位移(PSD),观察胸膜在不同区域的滑动情况,并根据两者计算 LUS。测量膈肌偏移(DE)、残余肺活量(RV)、总肺活量(TLC)、吸气量(IC)和功能残余肺活量(FRC)。我们描述了超声指标与反映 LH 的肺功能指标之间的相关性。我们采用了多元线性回归分析。结果:(1) COPD 稳定期患者的 LUS 与 RV、TLC、RV/TLC 和 FRC 呈正相关,与 IC 和 IC/TLC 呈负相关(r1=0.72,r2=0.41,r3=0.72,r4=0.70,r5=- 0.56,r6=- 0.65,P <0.001)。其相关性强于最大深吸气时的肺活量与相应肺功能指数之间的相关性(r1=- 0.41,r2=- 0.26,r3=- 0.40,r4=- 0.43,r5=0.30,r6=0.37,P <0.001)。(2)多元线性回归分析显示,LUS 与 IC/TLC 和 RV/TLC 显著相关。(3)以IC/TLC< 25%和RV/TLC> 60%作为重度LH的诊断标准,最大深吸气时LUS和DE诊断重度LH的ROC曲线下面积分别为0.914和0.385、0.845和0.543(P< 0.001):结论:肺部超声评分是评估 LH 的重要参数。LUS在最大深吸气时诊断重度LH的效果优于DE,有望成为评估LH的有效辅助工具。 关键词:慢性阻塞性肺疾病;肺过度充气;超声;胸膜滑动移位;肺功能
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lung Ultrasound Assessment of Lung Hyperinflation in Patients with Stable COPD: An Effective Diagnostic Tool
Purpose: To evaluate the degree of lung hyperinflation (LH) in patients with stable chronic obstructive pulmonary disease (COPD) by lung ultrasound score (LUS) and assess its value.
Patients and Methods: We conducted a study of 149 patients with stable COPD and 100 healthy controls recruited by the Second Affiliated Hospital of Fujian Medical University. The pleural sliding displacement (PSD) was measured, the sliding of the pleura in different areas was observed, and LUS was calculated from both of them. The diaphragm excursion (DE), residual capacity (RV), total lung capacity (TLC), inspiratory capacity (IC) and functional residual capacity (FRC) were measured. We described the correlation between ultrasound indicators and pulmonary function indicators reflecting LH. Multiple linear regression analysis was used. The ROC curves of LUS and DE were drawn to evaluate their diagnostic efficacy, and De Long method was used for comparison.
Results: (1) The LUS of patients with stable COPD were positively correlated with RV, TLC, RV/TLC and FRC and negatively correlated with IC and IC/TLC (r1=0.72, r2=0.41, r3=0.72, r4=0.70, r5=− 0.56, r6=− 0.65, P < 0.001). The correlation was stronger than that between DE at maximal deep inspiration and the corresponding pulmonary function indices (r1=− 0.41, r2=− 0.26, r3=− 0.40, r4=− 0.43, r5=0.30, r6=0.37, P < 0.001). (2) Multiple linear regression analysis showed that LUS were significantly correlated with IC/TLC and RV/TLC. (3) With IC/TLC< 25% and RV/TLC> 60% as the diagnostic criterion of severe LH, the areas under the ROC curves of LUS and DE at maximal deep inspiration for diagnosing severe LH were 0.914 and 0.385, 0.845 and 0.543, respectively (P < 0.001).
Conclusion: The lung ultrasound score is an important parameter for evaluating LH. LUS is better than DE at maximal deep inspiration for diagnosing severe LH and is expected to become an effective auxiliary tool for evaluating LH.

Keywords: chronic obstructive pulmonary disease, lung hyperinflation, ultrasound, pleural sliding displacement, pulmonary function
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来源期刊
CiteScore
5.10
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
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