Ju Chun-Rong, Chen Rong-Chang
Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2008 Aug;31(8):566-70.
To investigate the quadriceps strength in patients with stable chronic obstructive pulmonary disease (COPD), and the characteristics of quadriceps dysfunction in COPD patients.
All participants including 71 (male 54, female 17) patients with stable COPD and 60 (male 21, female 39) normal subjects underwent lung function tests, anthropometric measurements, quadriceps function assessments and physical activities evaluation. Quadriceps function was assessed by measurement of the maximal isometric volitional contraction (QMVC), endurance time and the maximal twitch tension. SPSS 12.0 was used to perform statistics. The results were presented as the (-x) +/- s for all variables that were normally distributed. Differences between the two groups (i.e., patients vs. controls) were analyzed using a two-tailed grouped t test. Differences between the groups within the COPD patients were analyzed using one-way ANOVA, and q-test was used to analyze the differences between them. Linear regression analysis was used to investigate the relationships between variables.
The mean QMVC was (42 +/- 8) kg, endurance time was (81 +/- 27) s, the maximal twitch tension was (13.9 +/- 6.7) kg in normal men, while they were (23 +/- 6) kg, (51 +/- 18) s and (7.0 +/- 2.3) kg respectively in their COPD counterparts (t value was 5.89 - 10.73, all P < 0.01). The mean QMVC was (29 +/- 5) kg, endurance time was (83 +/- 32) s and the maximal twitch tension was (7.4 +/- 2.1) kg in normal female subjects, while they were (16 +/- 4) kg, (56 +/- 8) s and (4.2 +/- 0.9) kg respectively in female COPD patients (t value was 3.47 - 9.35, all P < 0.01). Correlation analysis showed that QMVC positively correlated with lung function variables, body mass index and mid-thigh muscle circumference in COPD patients (r value was 0.27 - 0.76, all P < 0.01).
Our data showed that quadriceps dysfunction was common in COPD patients. QMVC was impaired to a greater extent than isometric endurance, and QMVC positively correlated with the severity of airflow obstruction. The maximal twitch tension induced by magnetic femoral nerve stimulation was an objective method to assess quadriceps strength.
研究稳定期慢性阻塞性肺疾病(COPD)患者的股四头肌力量,以及COPD患者股四头肌功能障碍的特点。
所有参与者包括71例(男性54例,女性17例)稳定期COPD患者和60例(男性21例,女性39例)正常受试者,均接受肺功能测试、人体测量、股四头肌功能评估及体力活动评价。通过测量最大等长随意收缩(QMVC)、耐力时间及最大抽搐张力来评估股四头肌功能。使用SPSS 12.0进行统计学分析。所有呈正态分布的变量结果均以(-x)±s表示。两组(即患者与对照组)之间的差异采用双侧成组t检验进行分析。COPD患者组内差异采用单因素方差分析,并用q检验分析组内差异。采用线性回归分析研究变量之间的关系。
正常男性的平均QMVC为(42±8)kg,耐力时间为(81±27)s,最大抽搐张力为(13.9±6.7)kg;而COPD男性患者相应指标分别为(23±6)kg、(51±18)s和(7.0±2.3)kg(t值为5.89 - 10.73,均P<0.01)。正常女性受试者的平均QMVC为(29±5)kg,耐力时间为(83±32)s,最大抽搐张力为(7.4±2.1)kg;而女性COPD患者相应指标分别为(16±4)kg、(56±8)s和(4.2±0.9)kg(t值为3.47 - 9.35,均P<0.01)。相关性分析显示,COPD患者的QMVC与肺功能变量、体重指数及大腿中部肌肉周长呈正相关(r值为0.27 - 0.76,均P<0.01)。
我们的数据表明,股四头肌功能障碍在COPD患者中很常见。QMVC受损程度大于等长耐力,且QMVC与气流阻塞严重程度呈正相关。股神经磁刺激诱导的最大抽搐张力是评估股四头肌力量的一种客观方法。