急性吉兰-巴雷综合征的呼吸肌评估
Respiratory Muscle Assessment in Acute Guillain-Barré Syndrome.
作者信息
Walterspacher S, Kirchberger A, Lambeck J, Walker D J, Schwörer A, Niesen W D, Windisch W, Hamzei F, Kabitz H J
机构信息
Clinic for Pneumology, Department of Internal Medicine, University Hospital Freiburg, Freiburg, Germany.
Department of Pneumology, Kliniken der Stadt Köln gGmbH Cologne, University of Witten/Herdecke, Witten, Germany.
出版信息
Lung. 2016 Oct;194(5):821-8. doi: 10.1007/s00408-016-9929-5. Epub 2016 Aug 9.
PURPOSE
Guillain-Barré Syndrome (GBS) is a life-threatening disease due to respiratory muscle involvement. This study aimed at objectively assessing the course of respiratory muscle function in GBS subjects within the first week of admission to an intensive care unit.
METHODS
Medical Research Council Sum Score (MRC-SS), vigorimetry, spirometry, and respiratory muscle function tests (inspiratory/expiratory muscle strength: PImax/PEmax, sniff nasal pressure: SnPna) were assessed twice daily. GBS Disability Score (GBS-DS) was assessed once daily. On days one (d1) and seven (d7), blood gases and twitch mouth pressure during magnetic phrenic nerve stimulation (Pmo,tw) were additionally evaluated.
RESULTS
Nine subjects were included. MRC-SS, vigorimetry, PImax, and SnPna increased between d1 and d7. GBS-DS, spirometry and Pmo,tw remained unaltered. Only SnPna correlated closely with the MRC-SS on both d1 (r = 0.77, p = 0.02) and d7 (r = 0.74, p = 0.02).
CONCLUSION
SnPna was the only parameter that correlated with MRC-SS, while the current gold standard of spirometry measurement did not.
目的
吉兰-巴雷综合征（GBS）是一种因呼吸肌受累而危及生命的疾病。本研究旨在客观评估重症监护病房收治的GBS患者入院第一周内呼吸肌功能的变化过程。
方法
每天评估两次医学研究委员会总分（MRC-SS）、握力计测量、肺活量测定和呼吸肌功能测试（吸气/呼气肌力量：最大吸气压/最大呼气压，嗅鼻压力：SnPna）。每天评估一次GBS残疾评分（GBS-DS）。在第1天（d1）和第7天（d7），额外评估血气和膈神经磁刺激期间的抽搐口部压力（Pmo,tw）。
结果
纳入9名受试者。d1至d7期间，MRC-SS、握力计测量、最大吸气压和SnPna升高。GBS-DS、肺活量测定和Pmo,tw保持不变。仅SnPna在d1（r = 0.77，p = 0.02）和d7（r = 0.74，p = 0.02）时均与MRC-SS密切相关。
结论
SnPna是唯一与MRC-SS相关的参数，而当前肺活量测定的金标准参数并不相关。
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