Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
Department of Physical Medicine and Rehabilitation, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
Spine (Phila Pa 1976). 2019 Oct 15;44(20):1441-1448. doi: 10.1097/BRS.0000000000003178.
A prospective study of cardiopulmonary function in patients with congenital scoliosis (CS).
To investigate the relationship of thoracic cage deformity and exercise tolerance in CS patients.
Congenital thoracic scoliosis and chest deformity lead to restrictive pulmonary dysfunction and in some severe cases cause cardiopulmonary failure. However, it is still unknown the relationship between thoracic deformity and exercise performance.
Patients with congenital thoracic spinal deformity were included and had radiological assessment of thoracic cage, pulmonary function testing, and cardiopulmonary exercise testing. Thoracic dimension including height, width, and depth were measured and geometry parameters were calculated. Two-tailed Pearson and Spearman correlation test and linear regression analysis were performed to investigate correlation of radiographic parameters, pulmonary function, and physical capacity.
Sixty patients (41 females and 19 males) were included, with an average age of 18.9 years. Patients with smaller thoracic height (P < 0.001) and width (P < 0.01) and larger depth (P < 0.05) had significantly worse static pulmonary function. In exercise testing, these patients showed significant tendency of ventilation insufficiency, including lower minute ventilation (P < 0.05), faster breathing frequency (P < 0.05), and smaller tidal volume (P < 0.01). Thoracic depth was negatively correlated to exercise capacity, reflected by work rate (P < 0.001), peak oxygen intake (P < 0.001), and heart rate (P = 0.043). Patients with abnormal thoracic geometry, especially a lower ratio of height to depth and a lower ratio of width to depth, have significantly worse static pulmonary function and exercise capacity (all P < 0.05).
Decreasing thoracic height and width results in restrictive pulmonary dysfunction. Distortion and asymmetry of the thoracic cage are associated with abnormal breathing pattern and reduction of exercise capacity.
先天性脊柱侧凸（CS）患者心肺功能的前瞻性研究。
研究胸廓畸形与 CS 患者运动耐量的关系。
先天性胸脊柱侧凸和胸廓畸形可导致限制性肺功能障碍，在某些严重情况下可导致心肺衰竭。然而，胸廓畸形与运动表现之间的关系尚不清楚。
纳入患有先天性胸脊柱畸形的患者，并进行胸廓放射学评估、肺功能测试和心肺运动测试。测量胸廓的高度、宽度和深度等维度，并计算几何参数。采用双尾 Pearson 和 Spearman 相关检验和线性回归分析，研究影像学参数、肺功能和体能之间的相关性。
共纳入 60 例患者（女性 41 例，男性 19 例），平均年龄为 18.9 岁。胸廓高度（P<0.001）和宽度（P<0.01）较小以及深度（P<0.05）较大的患者静态肺功能明显较差。在运动测试中，这些患者表现出明显的通气不足趋势，包括分钟通气量降低（P<0.05）、呼吸频率加快（P<0.05）和潮气量减少（P<0.01）。胸廓深度与运动能力呈负相关，表现为工作率（P<0.001）、峰值摄氧量（P<0.001）和心率（P=0.043）降低。胸廓几何形状异常的患者，尤其是胸廓高度与深度的比值较低和胸廓宽度与深度的比值较低的患者，其静态肺功能和运动能力明显较差（均 P<0.05）。
胸廓高度和宽度的减小导致限制性肺功能障碍。胸廓的变形和不对称与异常呼吸模式和运动能力降低有关。
3 级。
