Duiverman Marieke L, van Eykern Leo A, Vennik Peter W, Koëter Gerard H, Maarsingh Eric J W, Wijkstra Peter J
Department of Pulmonary Diseases/Home Mechanical Ventilation, University Hospital Groningen, 9700 RB Groningen, The Netherlands.
J Appl Physiol (1985). 2004 May;96(5):1723-9. doi: 10.1152/japplphysiol.00914.2003. Epub 2003 Dec 5.
In the present study, we assessed the reproducibility and responsiveness of transcutaneous electromyography (EMG) of the respiratory muscles in patients with chronic obstructive pulmonary disease (COPD) and healthy subjects during breathing against an inspiratory load. In seven healthy subjects and seven COPD patients, EMG signals of the frontal and dorsal diaphragm, intercostal muscles, abdominal muscles, and scalene muscles were derived on 2 different days, both during breathing at rest and during breathing through an inspiratory threshold device of 7, 14, and 21 cm H2O. For analysis, we used the logarithm of the ratio of the inspiratory activity during the subsequent loads and the activity at baseline [log EMG activity ratio (EMGAR)]. Reproducibility of the EMG was assessed by comparing the log EMGAR values measured at test days 1 and 2 in both groups. Responsiveness (sensitivity to change) of the EMG was assessed by comparing the log EMGAR values of the COPD patients to those of the healthy subjects at each load. During days 1 and 2, log EMGAR values of the diaphragm and the intercostal muscles correlated significantly. For the scalene muscles, significant correlations were found for the COPD patients. Although inspiratory muscle activity increased significantly during the subsequent loads in all participants, the COPD patients displayed a significantly greater increase in intercostal and left scalene muscle activity compared with the healthy subjects. In conclusion, the present study showed that the EMG technique is a reproducible and sensitive technique to assess breathing patterns in COPD patients and healthy subjects.
在本研究中，我们评估了慢性阻塞性肺疾病（COPD）患者和健康受试者在对抗吸气负荷呼吸时呼吸肌经皮肌电图（EMG）的可重复性和反应性。在7名健康受试者和7名COPD患者中，分别于2个不同日期采集了膈肌前部和背部、肋间肌、腹肌和斜角肌的EMG信号，包括静息呼吸时以及通过7、14和21 cm H2O吸气阈值装置呼吸时的信号。为了进行分析，我们使用了后续负荷期间吸气活动与基线活动比值的对数[肌电图活动比值对数（EMGAR）]。通过比较两组第1天和第2天测试时测得的EMGAR对数值得出EMG的可重复性。通过比较COPD患者与健康受试者在每个负荷下的EMGAR对数值得出EMG的反应性（对变化的敏感性）。在第1天和第2天，膈肌和肋间肌的EMGAR对数显著相关。对于斜角肌，在COPD患者中发现了显著相关性。尽管在所有参与者中，后续负荷期间吸气肌活动均显著增加，但与健康受试者相比，COPD患者肋间肌和左斜角肌活动的增加幅度显著更大。总之，本研究表明，EMG技术是一种可重复且敏感的技术，可用于评估COPD患者和健康受试者的呼吸模式。
