呼吸肌无力患者的呼吸肌力与咳嗽能力的关系
2010/07/07
摘要
目的：本试验旨在患有呼吸肌无力的患者中研究呼吸肌肌力与咳嗽能力的关系。
材料与方法：45名肌萎缩性脊髓侧索硬化症(ALS)患者及43名颈髓损伤(SCI)患者和42名杜氏肌营养不良症(DMD)患者入选本项研究。肺功能检测包括用力肺活量(FVC)、呼吸肌肌力（最大呼气压：MEP；最大吸气压：MIP）。分析呼吸肌肌力与咳嗽能力之间的关系。
结果：SCI组患者的卧位FVC（2,597 +/- 648 mL）显著高于坐位FVC（2,304 +/- 564 mL, P< 0.01）。相反，ALS组患者的坐位FVC（1,370 +/- 604 mL）高于卧位FVC（1,168 +/- 599 mL, P< 0.01）。DMD组患者的坐位（1,342 +/- 506 mL）和卧位（1,304 +/- 500 mL）FVC无显著差异。此外，所有患者的MEP和MIP均与咳嗽峰流量（PCF）相关（皮尔森相关分析：P< 0.01）。SCI组患者的MIP与PCF关系更为密切，而ALS组和DMD组患者的MEP与PCF相关性更为密切（多元回归分析：P< 0.01）。
结论：为了产生咳嗽流量，吸气肌肉肌力对于SCI患者更为重要，而对于ALS和DMD患者，呼气肌肉肌力更为重要。
Park JH, et al. Yonsei Med J. 2010 May;51(3):392-397.
How respiratory muscle strength correlates with cough capacity in patients with respiratory muscle weakness.
Park JH, Kang SW, Lee SC, Choi WA, Kim DH.
Department of Rehabilitation Medicine, Eulji University Hospital, Daejeon, Korea.
Abstract
PURPOSE: The purpose of this study is to investigate how respiratory muscle strength correlates to cough capacity in patients with respiratory muscle weakness.
MATERIALS AND METHODS: Forty-five patients with amyotrophic lateral sclerosis (ALS), 43 with cervical spinal cord injury (SCI), and 42 with Duchenne muscular dystrophy (DMD) were recruited. Pulmonary function tests including forced vital capacity (FVC) and respiratory muscle strength (maximal expiratory pressure, MEP; maximal inspiratory pressure, MIP) were performed. The correlation between respiratory muscle strength and cough capacity was analyzed.
RESULTS: In the SCI group, FVC in a supine position (2,597 +/- 648 mL) was significantly higher than FVC in a sitting position (2,304 +/- 564 mL, p < 0.01). Conversely, in the ALS group, FVC sitting (1,370 +/- 604 mL) was significantly higher than in supine (1,168 +/- 599 mL, p < 0.01). In the DMD group, there was no statistically significant difference between FVC while sitting (1,342 +/- 506 mL) and FVC while supine (1,304 +/- 500 mL). In addition, the MEP and MIP of all three groups showed a significant correlation with peak cough flow (PCF) (p < 0.01, Pearson’s correlation analysis). In the SCI group, MIP was more closely correlated with PCF, while in the ALS and DMD groups, MEP was more closely correlated with PCF (p < 0.01, multiple regression analysis).
CONCLUSION: To generate cough flow, inspiratory muscle strength is significantly more important for SCI patients, while expiratory muscle function is significantly more important for ALS and DMD patients.
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