间质性肺疾病（ILD）患者膈肌功能障碍的神经肌电图评估、危险因素及其对死亡率的影响：一项回顾性观察性研究

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research Pub Date : 2025-07-30 DOI:10.1016/j.resmer.2025.101196

Jules Milesi , Sophie Ng Wing Tin , Thomas Gille , Hilario Nunes , Simon Chauveau , Carole Planès , Guillaume Robbe , Yurdagül Uzunhan , Lucile Sesé

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引用次数: 0

摘要

膈肌功能障碍（DD）在各种呼吸系统疾病患者的呼吸困难、生活质量和预后中起着重要作用。然而，其在间质性肺疾病（ILDs）中的表征仍然有限。本研究旨在通过横膈膜神经肌电图（dENMG）和横膈膜复合肌动作电位（CMAP）分析来表征可能患有DD的ILD患者，并确定DD的预测因素及其对预后的影响。方法在我们的中心进行了一项回顾性单中心研究，包括2018年5月至2023年9月期间接受ENMG膈肌评估的所有连续ILD患者。收集临床资料、dENMG和其他评估。应用logistic回归分析膈肌CMAP异常与ILD特征的关系。生存率分析采用Kaplan-Meier曲线和经年龄和性别调整的cox模型。结果2018年5月至2023年9月期间，37例ILD患者因疑似DD接受了dENMG检查，结缔组织病相关ILD (CTD-ILD)[28例（76%）]是最常见的ILD亚型。根据dENMG， 13例（35%）有DD。DD患者以老年男性为主，冠状动脉疾病（CAD）患病率较高，非特异性间质性肺炎（NSIP）模式较少，与无DD患者相比，DD组预后更差，生存期缩短[平均29.3（±17.2）p = 0.04 vs 31.3个月（±18.3）]。在法国的一个ILD转诊中心，仅一小部分ILD患者怀疑有相关性DD，主要是CTD-ILD。在这些人中，只有三分之一的人被dENMG和异常的膈肌CMAP怀疑为DD。DD似乎与不良结果有关，但需要进一步研究更大的队列。

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Diaphragm dysfunction evaluated by electroneuromyography in patients with interstitial lung disease (ILD), risks factors and impact on mortality: a retrospective observational study

Introduction

Diaphragmatic dysfunction (DD) plays a significant role in dyspnea, quality of life, and prognosis in various respiratory diseases. However, its characterization in Interstitial Lung Diseases (ILDs) remains limited. This study aimed to characterize ILD patients with probable DD using diaphragmatic electroneuromyography (dENMG) and analysis of the diaphragm's compound muscle action potential (CMAP), and to determine predictive factors of DD and its prognostic impact.

Methods

A retrospective monocentric study was conducted in our center, including all consecutive ILD patients who underwent diaphragm evaluation with ENMG between May 2018 and September 2023. Clinical data, dENMG, and other assessments were collected. Association between abnormal diaphragm’s CMAP and ILD characteristics were analyzed using logistic regression. Survival was analyzed using Kaplan-Meier curves and cox model adjusted for age and sex.

Results

Between May 2018 and September 2023, thirty-seven ILD patients underwent an dENMG for suspected DD. Connective Tissue Disease-associated ILD (CTD-ILD) [28 (76 %)] was the most common ILD-subtype. Thirteen (35 %) had a DD according to dENMG. Patients with DD were predominantly older males, had a higher prevalence of coronary artery disease (CAD), and had less non-specific interstitial pneumonia (NSIP) pattern compared to patients without DD. The prognosis appeared to be worse in the DD group, with reduced survival [mean 29.3 (± 17.2) p = 0.04 vs 31.3 months (± 18.3)].

Discussion

In a French referral center for ILDs, suspicion of associated DD concerned only a small proportion of ILD patients, mainly with CTD-ILD. Among those, only a third had DD suspected by a dENMG and abnormal diaphragm’s CMAP. DD appears to be associated with unfavorable outcomes, although further research with larger cohorts is warranted.

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来源期刊

Respiratory Medicine and Research RESPIRATORY SYSTEM-

CiteScore

2.70

自引率

0.00%

发文量

审稿时长

50 days