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三级转诊中心随访的神经肌肉疾病患者的肺功能与吞咽功能之间的关系:一项横断面研究。

The relationship between pulmonary and swallowing functions in patients with neuromuscular diseases followed up by a tertiary referral center: a cross-sectional study.

机构信息

Departments of Speech Therapy and Physical Therapy, Hospital de Apoio de Brasília, Tertiary Referral Center of Neuromuscular Diseases, Brasília, Brazil.

Graduate Department of Health Sciences and Technologies, University of Brasília (UnB), Brasília, Brazil.

出版信息

Logoped Phoniatr Vocol. 2022 Jul;47(2):117-124. doi: 10.1080/14015439.2021.1879254. Epub 2021 Feb 15.

Abstract

INTRODUCTION

Respiratory muscle weakness is common in patients with neuromuscular diseases (NMD). This puts them at risk for dysphagia and other pulmonary complications.

OBJECTIVES

To investigate the relationship between pulmonary function and swallowing in NMD.

MATERIALS AND METHODS

In this cross-sectional study, medical records of patients undergoing treatment at the Tertiary Referral Center for Neuromuscular Diseases of Hospital de Apoio de Brasília, Brazil, were reviewed. Respiratory function was assessed through spirometry (FVC and FEV1 measured) and swallowing assessed by the Dysphagia Risk Evaluation Protocol and the Functional Oral Intake Scale.

RESULTS

Two hundred and twenty-two patients were included. Dysphagia was present in 46.8% of patients and impairment of pulmonary function in 64.0%. The mean FVC observed was 66.9% and FEV1 was 66.0%, indicating restrictive lung disease. A correlation between the decline of pulmonary and swallowing functions was observed in patients with NMDs (FVC vs. DREP,  = 0.46; FVC vs. FOIS,  = 0.42; FEV1 vs. DREP,  = 0.42; FEV1 vs. FOIS,  = 0.40, <.01). FVC and FEV1 values tend to be lower in patients with dysphagia in the context of NMD.

CONCLUSIONS

A positive correlation between pulmonary function and swallowing outcomes was observed in patients with NMD. Despite respiratory and swallowing impairment being widely present in the population with NMD, they require different treatments according to the disease's pathophysiology. Future studies should be conducted to explore the disease-specific relationship between pulmonary function and swallowing in patients with NMD.

摘要

简介

呼吸肌无力在神经肌肉疾病(NMD)患者中很常见。这使他们有发生吞咽困难和其他肺部并发症的风险。

目的

研究 NMD 患者的肺功能与吞咽功能之间的关系。

材料和方法

在这项横断面研究中,回顾了巴西巴西利亚三级神经肌肉疾病转诊中心接受治疗的患者的病历。通过肺活量测定法(测量 FVC 和 FEV1)评估呼吸功能,通过吞咽风险评估协议和功能性口腔摄入量表评估吞咽功能。

结果

共纳入 222 名患者。46.8%的患者存在吞咽困难,64.0%的患者存在肺功能障碍。观察到的平均 FVC 为 66.9%,FEV1 为 66.0%,表明存在限制性肺疾病。在 NMD 患者中观察到肺功能和吞咽功能下降之间存在相关性(FVC 与 DREP, = 0.46;FVC 与 FOIS, = 0.42;FEV1 与 DREP, = 0.42;FEV1 与 FOIS, = 0.40,<.01)。在 NMD 背景下,有吞咽困难的患者的 FVC 和 FEV1 值往往较低。

结论

在 NMD 患者中观察到肺功能与吞咽结果之间存在正相关。尽管呼吸和吞咽功能障碍在 NMD 人群中广泛存在,但它们需要根据疾病的病理生理学进行不同的治疗。未来的研究应该探讨 NMD 患者肺功能与吞咽功能之间的特定疾病相关性。

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