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强直性脊柱炎患者的膈肌运动及其与临床因素的关系:一项超声研究。

Diaphragmatic movements in ankylosing spondylitis patients and their association with clinical factors: an ultrasonographic study.

机构信息

Department of Radiodiagnostics, Trakya University Medical Faculty, Edirne, Turkey.

出版信息

Rheumatol Int. 2012 Feb;32(2):435-7. doi: 10.1007/s00296-010-1657-1. Epub 2010 Dec 1.

Abstract

We compared diaphragmatic motion between ankylosing spondylitis (AS) patients and controls, as assessed by the ultrasonographic method. We included 33 consecutive AS patients (19 males, 14 females) followed up at our center and 14 apparently healthy controls (8 males, 6 females) into our study. AS patients fulfilled the modified New York classification criteria for AS. Patients' demographic and clinical data, functional parameters, and radiographic findings were recorded down. By evaluating the motion of right and left diaphragm during deep expirium and inspirium, the mean diaphragmatic motion was determined by ultrasonography. Diaphragmatic motion in AS patients was less than in controls, but the difference was not significant (68.9 ± 17 mm vs. 77.8 ± 22.4 mm, P = 0.14). Diaphragmatic motion in AS patients who were active according to BASDAI score (>4) was not different from inactive patients (70.4 ± 20.5 vs. 67.5 ± 13.5, P > 0.05). The mean diaphragmatic motion had a positive correlation with occiput-to-wall distance (r = 0.35, P = 0.048); and negative correlations with cervical rotation (r = -0.45, P = 0.01) and modified Schober test (r = -0.34, P = 0.05) in AS patients. We did not detect any association of mean diaphragmatic motion with thoracic expansion on deep expiration. Diaphragmatic motion in AS does not differ significantly from the control group. Factors like disease activation, chest expansion, and the severity of radiographic findings do not affect diaphragmatic motion. There is no compensatory increase in diaphragmatic motion in AS.

摘要

我们通过超声方法比较了强直性脊柱炎(AS)患者和对照组的膈肌运动。我们纳入了 33 例连续的 AS 患者(19 名男性,14 名女性)和 14 名健康对照组(8 名男性,6 名女性)进行研究。AS 患者符合改良纽约分类标准。记录了患者的人口统计学和临床数据、功能参数和影像学发现。通过评估深呼气和吸气时右膈和左膈的运动,超声确定平均膈肌运动。AS 患者的膈肌运动小于对照组,但差异无统计学意义(68.9 ± 17mm 比 77.8 ± 22.4mm,P = 0.14)。根据 BASDAI 评分(>4),活动期的 AS 患者的膈肌运动与非活动期患者无差异(70.4 ± 20.5 比 67.5 ± 13.5,P > 0.05)。平均膈肌运动与枕墙距离呈正相关(r = 0.35,P = 0.048);与颈椎旋转(r = -0.45,P = 0.01)和改良 Schober 试验(r = -0.34,P = 0.05)呈负相关。我们没有发现平均膈肌运动与深呼气时的胸廓扩张有任何关联。AS 患者的膈肌运动与对照组无显著差异。疾病活动度、胸廓扩张和影像学发现的严重程度等因素不会影响膈肌运动。AS 患者的膈肌运动没有代偿性增加。

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