中国慢性阻塞性肺疾病患者股四头肌功能受损的相关因素。
Factors associated with impairment of quadriceps muscle function in Chinese patients with chronic obstructive pulmonary disease.
作者信息
Ju Chunrong, Chen Rongchang
机构信息
The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
出版信息
PLoS One. 2014 Feb 18;9(2):e84167. doi: 10.1371/journal.pone.0084167. eCollection 2014.
BACKGROUND
Quadriceps muscle dysfunction is well confirmed in chronic obstructive pulmonary disease (COPD) and reported to be related to a higher risk of mortality. Factors contributing to quadriceps dysfunction have been postulated, while not one alone could fully explain it and there are few reports on it in China. This study was aimed to investigate the severity of quadriceps dysfunction in patients with COPD, and to compare quadriceps muscle function in COPD and the healthy elderly.
METHODS
Quadriceps strength and endurance capabilities were investigated in 71 COPD patients and 60 age-matched controls; predicted values for quadriceps strength and endurance were calculated using regression equations (incorporating age, gender, anthropometric measurements and physical activities), based on the data from controls. Potential parameters related to quadriceps dysfunction in COPD were identified by stepwise regression analysis.
RESULTS
Mean values of quadriceps strength was 46% and endurance was 38% lower, in patients with COPD relative to controls. Gender, physical activities and anthropometric measurements were predictors to quadriceps function in the controls. While in COPD, forced expiratory volume in 1 second percentage of predicted value (FEV1% pred), nutritional depletion, gender and physical inactivity were identified as independent factors to quadriceps strength (R(2) = 0.72); FEV1%pred, thigh muscle mass, serum levels of tumor necrosis factor-alpha (TNF-α) and gender were correlated to quadriceps endurance variance, with each p<0.05.
CONCLUSION
Quadriceps strength and endurance capabilities are both substantially impaired in Chinese COPD patients, with strength most affected. For the controls, physical activity is most important for quadriceps function. While for COPD patients, quadriceps dysfunction is related to multiple factors, with airflow limitation, malnutrition and muscle disuse being the main ones.
背景
股四头肌功能障碍在慢性阻塞性肺疾病（COPD）中已得到充分证实，据报道与更高的死亡风险相关。虽然已经推测了导致股四头肌功能障碍的因素，但没有一个因素能够完全解释它，并且在中国关于这方面的报道很少。本研究旨在调查COPD患者股四头肌功能障碍的严重程度，并比较COPD患者与健康老年人的股四头肌功能。
方法
对71例COPD患者和60例年龄匹配的对照组进行股四头肌力量和耐力能力的研究；根据对照组的数据，使用回归方程（纳入年龄、性别、人体测量学指标和体力活动）计算股四头肌力量和耐力的预测值。通过逐步回归分析确定与COPD患者股四头肌功能障碍相关的潜在参数。
结果
与对照组相比，COPD患者股四头肌力量的平均值低46%，耐力低38%。性别、体力活动和人体测量学指标是对照组股四头肌功能的预测因素。而在COPD患者中，1秒用力呼气容积占预计值百分比（FEV1%pred）、营养消耗、性别和体力活动不足被确定为股四头肌力量的独立影响因素（R² = 0.72）；FEV1%pred、大腿肌肉质量、血清肿瘤坏死因子-α（TNF-α）水平和性别与股四头肌耐力差异相关，各p<0.05。
结论
中国COPD患者的股四头肌力量和耐力能力均受到严重损害，其中力量受影响最大。对于对照组，体力活动对股四头肌功能最为重要。而对于COPD患者，股四头肌功能障碍与多种因素有关，气流受限、营养不良和肌肉废用是主要因素。
Zotero 插件