膈肌超声是一种影像学生物标志物，可区分加重期和稳定期慢性阻塞性肺疾病。
Diaphragm Ultrasound is an Imaging Biomarker that Distinguishes Exacerbation Status from Stable Chronic Obstructive Pulmonary Disease.
机构信息
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
出版信息
Int J Chron Obstruct Pulmon Dis. 2022 Jan 4;17:3-12. doi: 10.2147/COPD.S341484. eCollection 2022.
BACKGROUND
Evaluating the diaphragm muscle in chronic obstructive pulmonary disease (COPD) is important. However, the role of diaphragm ultrasound (DUS) in distinguishing the exacerbation status of COPD (AECOPD) is not fully understood. We set this study to evaluate the role of DUS as a biomarker for distinguishing the AECOPD.
METHODS
COPD patients who underwent DUS were enrolled between March 2020 and November 2020. The diaphragm thickening fraction (TF) and diaphragm excursion (DE) during maximal deep breathing were measured. Patients were divided into exacerbation and stable groups. Demographics, lung function, and DUS findings were compared between the two groups. Receiver operating characteristic curve and univariate/multivariate logistic regression analyses were performed.
RESULTS
Fifty-five patients were enrolled. The exacerbation group had a lower body mass index (BMI) (20.9 vs 24.2, = 0.003), lower TF (94.8 ± 8.2% vs 158.4 ± 83.5%, = 0.010), and lower DE (30.8 ± 11.1 mm vs 40.5 ± 12.5 mm, = 0.007) compared to stable group. The areas under the TF (0.745) and DE (0.721) curves indicated fair results for distinguishing AECOPD. The patients were divided into low and high TF and DE groups based on calculated cut-off values. Low TF (odds ratio [OR] 8.40; 95% confidence interval [CI] 1.55-45.56) and low DE (OR 11.51; 95% CI 1.15-115.56) were associated with AECOPD after adjusting for age, sex, BMI, and lung functions.
CONCLUSION
DUS showed the possibility of an imaging biomarker distinguishing AECOPD from stable status.
背景
评估慢性阻塞性肺疾病（COPD）患者的膈肌很重要。然而，膈肌超声（DUS）在区分 COPD 急性加重（AECOPD）状态方面的作用尚未完全明确。我们开展这项研究旨在评估 DUS 作为区分 AECOPD 的生物标志物的作用。
方法
本研究纳入了 2020 年 3 月至 2020 年 11 月期间进行 DUS 的 COPD 患者。测量最大深呼吸时的膈肌增厚分数（TF）和膈肌移动度（DE）。将患者分为加重组和稳定组。比较两组患者的人口统计学、肺功能和 DUS 结果。进行了受试者工作特征曲线和单因素/多因素逻辑回归分析。
结果
共纳入 55 例患者。与稳定组相比，加重组的体质指数（BMI）更低（20.9 比 24.2， = 0.003），TF 更低（94.8 ± 8.2% 比 158.4 ± 83.5%， = 0.010），DE 更低（30.8 ± 11.1 mm 比 40.5 ± 12.5 mm， = 0.007）。TF（0.745）和 DE（0.721）曲线下面积表明，区分 AECOPD 的结果为中等。根据计算出的截断值将患者分为低 TF 和低 DE 组。在校正年龄、性别、BMI 和肺功能后，低 TF（比值比 [OR] 8.40；95%置信区间 [CI] 1.55-45.56）和低 DE（OR 11.51；95% CI 1.15-115.56）与 AECOPD 相关。
结论
DUS 显示了一种成像生物标志物在区分 AECOPD 与稳定状态方面的可能性。
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