Hoang Van, Li Gloria W, Kao Christina C, Dronavalli Goutham, Parulekar Amit D
Section of Pulmonary, Critical Care and Sleep, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA.
Clin Transplant. 2017 Mar;31(3). doi: 10.1111/ctr.12897. Epub 2017 Jan 27.
This study aimed to determine predictors of pectoralis muscle area (PMA) and assess change in PMA following lung transplantation and its relationship to outcomes.
A retrospective review of 88 lung transplant recipients at a single center was performed. PMA was determined on a single axial slice from chest computerized tomography. Pectoralis muscle index (PMI) was calculated from the PMA divided by the height squared.
PMI decreased post-transplantation (8.1±2.8 cm /m pre-transplantation, 7.5±2.9 cm /m at 6 months, and 7.6±2.7 cm /m at 12 months, P<.05). Chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) were predictors of pre-transplant PMI (β=-2.3, P=.001 for COPD; β=2.1, P<.001 for ILD) and percent change in PMI at 12 months post-transplantation relative to baseline (β=19.2, P=.04 for COPD; β=-20.1, P=.01 for ILD). Patients in the highest quartile for PMI change at 12 months had fewer ventilator days compared with patients in the other quartiles (P=.03).
Underlying diagnosis was a significant predictor of both pre-transplantation PMI and change in PMI post-transplantation. Further studies of PMI are needed to determine its clinical utility in predicting outcomes following lung transplantation.
本研究旨在确定胸肌面积（PMA）的预测因素，评估肺移植后PMA的变化及其与预后的关系。
对单一中心的88例肺移植受者进行回顾性研究。通过胸部计算机断层扫描的单个轴向切片确定PMA。胸肌指数（PMI）通过PMA除以身高平方计算得出。
移植后PMI降低（移植前为8.1±2.8 cm²/m²，6个月时为7.5±2.9 cm²/m²，12个月时为7.6±2.7 cm²/m²，P<0.05）。慢性阻塞性肺疾病（COPD）和间质性肺疾病（ILD）是移植前PMI的预测因素（COPD的β=-2.3，P=0.001；ILD的β=2.1，P<0.001）以及移植后12个月时PMI相对于基线的变化百分比（COPD的β=19.2，P=0.04；ILD的β=-20.1，P=0.01）。与其他四分位数的患者相比，移植后12个月PMI变化处于最高四分位数的患者机械通气天数更少（P=0.03）。
潜在诊断是移植前PMI和移植后PMI变化的重要预测因素。需要对PMI进行进一步研究以确定其在预测肺移植预后方面的临床效用。
