Poberezhets Vitalii, Mostovoy Yuriy, Demchuk Hanna
Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
Lung India. 2019 May-Jun;36(3):188-192. doi: 10.4103/lungindia.lungindia_185_18.
Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) contributes to increased systemic inflammation, oxidative stress, hypoxia, hypercapnia and other risk factors of the skeletal muscle dysfunction.
This study aimed to determine whether the frequency of the COPD exacerbations promotes deterioration of the skeletal muscle dysfunction in patients with COPD and to figure out which characteristics of the muscles will reflect this changes.
We examined 98 male COPD patients, mean age 60.4±11.2 years, GOLD groups B, C, D. To assess the degree of skeletal muscle dysfunction we used hand-grip strength, 6-minute walk test, bioelectrical impedance analysis. Quality of life was evaluated using St. George's respiratory questionnaire (SGRQ).
Increase in the frequency of COPD exacerbations was associated with the decrease in the 6-minute walk test distance (r= -0.214, P = 0.034) and with the rise of sarcopenia according to the results of bioelectrical impedance analysis - lower fat-free mass index (r = -0.201, P = 0.047). Frequency of COPD exacerbations had a weak correlation with the degree of the activity limitation component of SGRQ (r = 0.436, P < 0.001).
COPD exacerbation plays an important role in progression of the skeletal muscle dysfunction. It decreases endurance of the skeletal muscles, diminishing their size, which manifests itself in reduced exercise tolerance. Increase in the frequency of the COPD exacerbations also worsens all components of the life quality.
慢性阻塞性肺疾病(COPD)急性加重会导致全身炎症加剧、氧化应激、缺氧、高碳酸血症以及骨骼肌功能障碍的其他危险因素增加。
本研究旨在确定COPD急性加重的频率是否会促进COPD患者骨骼肌功能障碍的恶化,并找出哪些肌肉特征会反映这种变化。
我们检查了98名男性COPD患者,平均年龄60.4±11.2岁,GOLD分级为B、C、D级。为评估骨骼肌功能障碍的程度,我们使用了握力、6分钟步行试验、生物电阻抗分析。使用圣乔治呼吸问卷(SGRQ)评估生活质量。
根据生物电阻抗分析结果,COPD急性加重频率增加与6分钟步行试验距离缩短(r = -0.214,P = 0.034)以及肌肉减少症增加相关——无脂肪质量指数降低(r = -0.201,P = 0.047)。COPD急性加重频率与SGRQ活动受限部分的程度呈弱相关(r = 0.436,P < 0.001)。
COPD急性加重在骨骼肌功能障碍的进展中起重要作用。它会降低骨骼肌的耐力,减小其尺寸,这表现为运动耐力下降。COPD急性加重频率增加也会使生活质量的所有方面恶化。