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疾病严重程度对帕金森病呼吸阻抗的影响。

Effect of Disease Severity on Respiratory Impedance in Parkinson's Disease.

作者信息

Sampath Meghashree, Srivastava Achal Kumar, Goyal Vinay, Jaryal Ashok Kumar, Deepak Kishore Kumar, Talwar Anjana

机构信息

Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Ann Neurosci. 2020 Apr;27(2):63-66. doi: 10.1177/0972753120960265. Epub 2020 Nov 9.

Abstract

BACKGROUND

Parkinson's disease (PD) is a progressive neurodegenerative disorder. PD has been traditionally perceived as a motor disorder. However, it is frequently associated with pulmonary dysfunction which has been assessed by Spirometry, an effort-dependent technique.

PURPOSE

To evaluate in patients with PD the effect of disease severity on respiratory impedance using Impulse Oscillometry (IOS) and to correlate with Spirometry.

METHODS

The study was conducted on 30 patients diagnosed with PD. Pulmonary function was assessed by IOS and spirometer. IOS is an effort-independent technique that uses sound waves of different frequencies to measure airway resistance. Spirometer measures the lung volume and generates flow-volume and volume-time relationship.

RESULTS

The mean age of patients was 60.1±9.45. Resistance at 5 Hz (R5) was found to be negatively correlated with forced expiratory volume in the first second of the FVC manoeuver (FEV) ( = -0.628, = .002), FEV/FVC (forced vital capacity) ( = -0.487, = .025), and PEF ( = -0.599, = .004), and resistance at 20 Hz (R20) with FEV ( = -0.474, = .029) and PEF ( = -0.522, = .015). There was significant increase in R5 (0.32(0.36-0.28) vs 0.47(0.60-0.36); = .04) and R20 (0.25(0.28-0.20) vs 0.30(0.40-0.25); = .04) in stage II as compared to stage I of Hoehn-Yahr scale.

CONCLUSION

IOS might be a promising tool for diagnosis of respiratory dysfunction in addition to Spirometry, especially in cases where patients are not able to perform forced manoeuvers.

摘要

背景

帕金森病(PD)是一种进行性神经退行性疾病。传统上,PD被视为一种运动障碍。然而,它常与肺功能障碍相关,肺功能障碍已通过肺活量测定法进行评估,这是一种依赖用力的技术。

目的

使用脉冲振荡法(IOS)评估PD患者疾病严重程度对呼吸阻抗的影响,并与肺活量测定法进行相关性分析。

方法

对30例诊断为PD的患者进行研究。通过IOS和肺活量计评估肺功能。IOS是一种无需用力的技术,它使用不同频率的声波来测量气道阻力。肺活量计测量肺容积,并生成流量-容积和容积-时间关系。

结果

患者的平均年龄为60.1±9.45。发现5Hz时的阻力(R5)与用力肺活量(FVC)动作第一秒用力呼气量(FEV)呈负相关(r = -0.628,p = 0.002)、FEV/FVC(用力肺活量)呈负相关(r = -0.487,p = 0.025)以及与呼气峰值流速(PEF)呈负相关(r = -0.599,p = 0.004),20Hz时的阻力(R20)与FEV呈负相关(r = -0.474,p = 0.029)以及与PEF呈负相关(r = -0.522,p = 0.015)。与Hoehn-Yahr量表I期相比,II期的R5(0.32(0.36 - 0.28)对0.47(0.60 - 0.36);p = 0.04)和R20(0.25(0.28 - 0.20)对0.30(0.40 - 0.25);p = 0.04)有显著增加。

结论

除肺活量测定法外,IOS可能是诊断呼吸功能障碍的一种有前景的工具,尤其是在患者无法进行用力动作的情况下。

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本文引用的文献

8
Pulmonary functions in Parkinson's disease.帕金森病中的肺功能
Indian J Chest Dis Allied Sci. 2005 Oct-Dec;47(4):251-7.
9
Standardisation of spirometry.肺活量测定法的标准化
Eur Respir J. 2005 Aug;26(2):319-38. doi: 10.1183/09031936.05.00034805.
10
Autonomic Nervous System Dysfunction in Parkinson's Disease.帕金森病中的自主神经系统功能障碍
Curr Treat Options Neurol. 2003 Mar;5(2):149-160. doi: 10.1007/s11940-003-0005-0.

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