Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Respiratory Medicine and Allergy, Tosei General Hospital, Nagoya, Japan.
Sci Rep. 2020 Feb 11;10(1):2312. doi: 10.1038/s41598-020-59100-5.
Computed tomography (CT) assessment of the cross-sectional area of the erector spinae muscles (ESM) can be used to evaluate sarcopenia and cachexia in patients with lung diseases. This study aimed to confirm whether serial changes in ESM are associated with survival in patients with idiopathic pulmonary fibrosis (IPF). Data from consecutive patients with IPF who were referred to a single centre were retrospectively reviewed. We measured the ESM at the level of the 12th thoracic vertebra on CT images at referral and 6 months later (n = 119). The follow-up time was from 817-1633 days (median, 1335 days) and 59 patients (49.6%) died. A univariate Cox regression analysis showed that the decline in % predicted forced vital capacity (FVC) (Hazard ratios [HR] 1.041, 95% confidence interval [CI] 1.013-1.069, P = 0.004), the decline in body mass index (BMI) (HR 1.084, 95% CI 1.037-1.128; P < 0.001) and that in ESM (HR 1.057, 95% CI 1.027-1.086; P < 0.001) were prognostic factors. For multivariate analyses, the decline in ESM (HR 1.039, 95% CI 1.007-1.071, P = 0.015) was a significant prognostic factor, while those in % FVC and BMI were discarded. Early decrease in ESM may be a useful predictor of prognosis in patients with IPF.
计算机断层扫描（CT）评估竖脊肌（ESM）的横截面积可用于评估肺部疾病患者的肌肉减少症和恶病质。本研究旨在确认 ESM 的连续变化是否与特发性肺纤维化（IPF）患者的生存相关。回顾性分析了连续就诊于一家中心的 IPF 患者的数据。我们在 CT 图像上测量了第 12 胸椎水平的 ESM，分别在就诊时和 6 个月后（n=119）进行测量。随访时间为 817-1633 天（中位数 1335 天），59 名患者（49.6%）死亡。单变量 Cox 回归分析显示，预计用力肺活量（FVC）下降（危险比[HR] 1.041，95%置信区间[CI] 1.013-1.069，P=0.004）、体重指数（BMI）下降（HR 1.084，95% CI 1.037-1.128；P<0.001）和 ESM 下降（HR 1.057，95% CI 1.027-1.086；P<0.001）是预后因素。多变量分析中，ESM 下降（HR 1.039，95% CI 1.007-1.071，P=0.015）是一个显著的预后因素，而 FVC 和 BMI 的下降则被排除在外。ESM 的早期下降可能是 IPF 患者预后的一个有用预测指标。
