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在没有残疾的多发性硬化症患者中进行一氧化碳弥散量和呼吸肌功能测试是否有用?

Is it useful to perform carbon monoxide diffusion capacity and respiratory muscle function tests in patients with multiple sclerosis without disability?

机构信息

Neurology Postgraduate Program, Federal University of the State of Rio de Janeiro,, Rio de Janeiro, Brazil.

出版信息

Respirology. 2012 Jul;17(5):869-75. doi: 10.1111/j.1440-1843.2012.02191.x.

Abstract

BACKGROUND AND OBJECTIVE

Impairment of respiratory function has been described in end-stage multiple sclerosis (MS), as well as in patients with mild to severe disability. No data are available regarding the respiratory function of MS patients without disability. The objective of this study was to assess the pulmonary function, respiratory muscle strength and carbon monoxide diffusion capacity of the lungs (DL(CO)) in patients with relapsing-remitting multiple sclerosis (RRMS) without disability.

METHODS

Twenty-seven RRMS patients and 25 healthy control subjects were recruited. All subjects underwent clinical and neurological examination, and spirometry; lung volumes, DL(CO) and maximal respiratory pressures were measured. All subjects were rated on the Modified Fatigue Impact Scale and Fatigue Severity Scale scales.

RESULTS

There were no significant differences in age, gender, height, weight or body mass index between the groups. The mean duration of illness in the MS group was 5.44 ± 3.74 years, and the mean Expanded Disability Status Scale was 0.62 ± 0.65. The mean values for total lung capacity, forced expiratory volume in 1 s (FEV(1)) and FEV(1) /FVC were normal in both groups. Fifteen RRMS patients exhibited a reduction in maximal expiratory pressure (MEP), but only one patient exhibited a reduction in maximal inspiratory pressure. The mean values for DL(CO) were lower in RRMS patients (P = 0.0004) than in the control group. DL(CO) was decreased in 15 (55.55%), out of 27 RRMS patients. The fatigue scale results were not correlated with pulmonary function test results

CONCLUSIONS

DL(CO) and MEP may be impaired in RRMS patients without disability.

摘要

背景与目的

在终末期多发性硬化症(MS)以及轻度至重度残疾患者中,已经描述了呼吸功能受损的情况。但是,对于没有残疾的 MS 患者的呼吸功能,尚无相关数据。本研究的目的是评估无残疾的复发性缓解型多发性硬化症(RRMS)患者的肺功能、呼吸肌力量和肺一氧化碳弥散量(DL(CO))。

方法

招募了 27 名 RRMS 患者和 25 名健康对照者。所有患者均接受了临床和神经学检查以及肺活量检查;测量了肺容积、DL(CO)和最大呼吸压。所有患者均接受了改良疲劳影响量表和疲劳严重程度量表的评分。

结果

两组在年龄、性别、身高、体重或体重指数方面均无显著差异。MS 组的平均病程为 5.44±3.74 年,扩展残疾状态量表评分为 0.62±0.65。两组的总肺容量、1 秒用力呼气量(FEV(1))和 FEV(1)/FVC 的平均值均正常。15 名 RRMS 患者表现出最大呼气压力(MEP)降低,但仅有 1 名患者表现出最大吸气压力降低。RRMS 患者的 DL(CO)平均值低于对照组(P=0.0004)。27 名 RRMS 患者中有 15 名(55.55%)的 DL(CO)降低。疲劳量表的结果与肺功能检查结果无关。

结论

无残疾的 RRMS 患者可能存在 DL(CO)和 MEP 受损的情况。

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