Memorial Bahcelievler Hospital, Department of Pulmonology, Istanbul, Turkey; Koc University Hospital, Department of Pulmonary Medicine, Istanbul, Turkey.
Koc University Hospital, Department of Neurology, Istanbul, Turkey.
Respir Med. 2022 Aug-Sep;200:106931. doi: 10.1016/j.rmed.2022.106931. Epub 2022 Jul 15.
The patients with neuromuscular diseases (NMD) are very fragile and it is hard to evaluate respiratory involvement of the primary disease in this group. Therefore, our study aimed to reveal the relationship between pulmonary function tests (PFT) and impulse oscillometry (IOS) and their correlation with respiratory clinical findings in NMD.
A total of 86 consecutive patients with NMD were included. The clinical findings of respiratory involvement, PFT, and IOS results of the patients were analyzed.
Forty patients out of 86 were female. There were 29 patients with amyotrophic lateral sclerosis, four patients with myasthenia gravis, and 53 patients with muscular dystrophies/myopathies. According to the PFT results, 47 patients had restrictive PFT. However, there was no difference in IOS parameters when we compared the patients according to restrictions in PFT. A positive correlation was found with FVC %pred and X. PEF %pred values were positively correlated with X, X, and X, and negatively correlated with A and R. The patients with worse swallowing capability had increased R levels, and more negative X levels. The shortness of breath led to lower FEV %pred., higher R, A and R, and also more negative X, X, and X.
Clinically reported dysphagia, a decreased capability of coughing, and shortness of breath in patients with NMD make R increase in general, but X parameters, which mainly express rib cage elasticity, turn more negative. In patients with NMD, IOS monitoring may help in evaluating the regression in respiratory functions, however, future studies are needed to understand more.
神经肌肉疾病(NMD)患者非常脆弱,很难评估此类患者的原发性疾病的呼吸受累情况。因此,我们的研究旨在揭示肺功能检查(PFT)和脉冲震荡(IOS)之间的关系,以及它们与 NMD 患者的呼吸临床发现的相关性。
共纳入 86 例连续的 NMD 患者。分析了患者的呼吸受累临床发现、PFT 和 IOS 结果。
86 例患者中有 40 例为女性。其中 29 例为肌萎缩侧索硬化症患者,4 例为重症肌无力患者,53 例为肌肉萎缩症/肌病患者。根据 PFT 结果,47 例患者存在限制性 PFT。然而,当我们根据 PFT 受限情况对患者进行比较时,IOS 参数没有差异。FVC%pred 和 X. PEF%pred 值与 X、X 和 X 呈正相关,与 A 和 R 呈负相关。吞咽能力较差的患者 R 值升高,X 值更负。呼吸困难导致 FEV%pred.降低,R、A 和 R 升高,X、X 和 X 值更负。
NMD 患者报告的临床吞咽困难、咳嗽能力下降和呼吸困难会导致 R 值普遍升高,但主要反映胸廓弹性的 X 参数则变得更负。在 NMD 患者中,IOS 监测可能有助于评估呼吸功能的下降,但需要进一步的研究来了解更多信息。