Arora N S, Rochester D F
Chest. 1987 May;91(5):719-24. doi: 10.1378/chest.91.5.719.
To assess the effect of COPD on diaphragm muscle dimensions, we measured diaphragm muscle mass, thickness, area, and lengths in 18 COPD patients at necropsy. We compared these results with data obtained from 22 non-COPD patients matched with regard to age, height, weight, and sex distribution. In the COPD patients, diaphragm muscle mass was 213 +/- SD 69 g, thickness was .320 +/- .055 cm, area was 647 +/- 160 cm2, coronal muscle length was 27.8 +/- 4.0 cm and sagittal muscle length was 15.8 +/- 2.8 cm. These values were within +/- 8 percent of the comparable values in the non-COPD patients, with no significant differences. There was no correlation between diaphragm length and lung volume in 13 COPD patients with TLC and ten with RV measurements. We conclude that over the range of lung volume encountered (TLC 135 +/- 28 percent predicted, RV 102 +/- 29 percent predicted TLC), there is no evidence for permanent shortening of the diaphragm.
为评估慢性阻塞性肺疾病(COPD)对膈肌尺寸的影响,我们在尸检时测量了18例COPD患者的膈肌质量、厚度、面积和长度。我们将这些结果与从22例在年龄、身高、体重和性别分布方面相匹配的非COPD患者获得的数据进行了比较。在COPD患者中,膈肌质量为213±标准差69克,厚度为0.320±0.055厘米,面积为647±160平方厘米,冠状肌长度为27.8±4.0厘米,矢状肌长度为15.8±2.8厘米。这些值在非COPD患者的可比数值的±8%范围内,无显著差异。在13例进行了肺总量(TLC)测量的COPD患者和10例进行了残气量(RV)测量的患者中,膈肌长度与肺容积之间无相关性。我们得出结论,在所遇到的肺容积范围内(TLC为预测值的135±28%,RV为预测TLC的102±29%),没有证据表明膈肌会永久性缩短。