| 章晓伟.膈肌功能评估在COPD患者中的应用及与BODE指数相关性分析[J].浙江中西医结合杂志,2026,36(7): |
| 膈肌功能评估在COPD患者中的应用及与BODE指数相关性分析 |
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| 投稿时间：2024-12-06 修订日期：2026-06-15 |
| DOI： |
| 中文关键词: 膈肌功能 超声 慢性阻塞性肺疾病 膈肌形态学 BODE指数 |
| 英文关键词:Diaphragm function Ultrasound Chronic obstructive pulmonary disease Diaphragm morphology BODE index |
| 基金项目: |
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| 中文摘要: |
| 目的 膈肌功能超声评估慢性阻塞性肺疾病(COPD)患者膈肌形态学指标情况及与BODE(B为体重指数,O为气流阻塞,D为呼吸困难,E为运动能力)指数的关系。方法 选取2023年10月-2024年10月本院收治的82例COPD患者为COPD组,另选取同期健康体检患者60例最为对照组,均行肺功能检查、膈肌功能超声、6分钟步行距离、呼吸困难程度检查以及BODE指数评分指标评估,比较COPD组和对照组以及不同严重程度COPD组间上述指标间差异,分析COPD患者膈肌形态学指标情况及与BODE指数相关性,分析膈肌形态学指标及BODE指数对COPD患者急性加重的预测分析。结果 COPD组患者FEV1、FEV1/FVC、6分钟步行距离、mMRC、BODE指数、膈肌移动度、TD和TF均与对照组具有显著性差异(P<0.05)；轻度组、中度组和重度组患者间FEV1、FEV1/FVC、6分钟步行距离、mMRC、BODE指数、膈肌移动度、TD和TF均具有显著性差异(P<0.05)；相关性分析显示,平静呼吸和深吸气时膈肌移动度、TD和TF与BODE指数呈负相关(P<0.05)；ROC曲线显示,膈肌形态学指标联合预测(平静呼吸和深吸气时膈肌移动度、TD和TF)、BODE指数预测COPD患者急性加重的ROC曲线AUC值依次为0.819和0.746。结论 COPD患者膈肌形态学指标降低,且随着气流受限严重程度增加而逐渐降低,与BODE指数呈负相关。膈肌形态学指标、BODE指数可作为预测COPD患者严重程度方法。 |
| 英文摘要: |
| Objective To evaluate the morphological indicators of diaphragm in patients with chronic obstructive pulmonary disease (COPD) by diaphragm function ultrasound and the relationship with BODE index (B: body mass index, O: airflow obstruction, D: dyspnea, E: exercise capacity). Methods 82 patients with COPD admitted to the hospital from October 2023 to October 2024 were selected as COPD group, and 60 healthy subjects with physical examination were included in control group. All patients underwent pulmonary function examination, diaphragm function ultrasound, 6-minute walking distance, dyspnea degree examination and BODE index score evaluation. The differences in the above indicators were compared between COPD group and control group and among patients with different severities in COPD group. The morphological indicators of diaphragm in COPD patients and the correlation with BODE index were analyzed. The predictive analysis of diaphragm morphological indicators and BODE index on acute exacerbation in COPD patients was analyzed. Results There were significant differences in FEV1, FEV1/FVC, 6-minute walking distance, mMRC, BODE index, diaphragm mobility, TD and TF between COPD group and control group (P<0.05). The FEV1, FEV1/FVC, 6-minute walking distance, mMRC, BODE index, diaphragm mobility, TD and TF were significantly different among mild group, moderate group and severe group (P<0.05). Correlation analysis showed that diaphragm mobility, TD and TF during quiet breathing and deep inspiration were negatively correlated with BODE index (P<0.05). The ROC curve shows that the AUC values of the combined prediction of diaphragmatic morphological indicators (diaphragmatic mobility, TD and TF during calm breathing and deep inhalation) and BODE index for predicting acute exacerbation in COPD patients are 0.819 and 0.746, respectively. Conclusion The morphological indicators of diaphragm in patients with COPD are decreased, and are gradually decreased with the increase of severity of airflow limitation, which is negatively correlated with BODE index. Diaphragm morphological indicators and BODE index can be used as a method to predict the severity of COPD patients. |
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