Department of Ultrasound, Chengdu First People's Hospital, Chengdu, Sichuan, 610041, People's Republic of China.
School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, 637100, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2022 Aug 23;17:1921-1928. doi: 10.2147/COPD.S374945. eCollection 2022.
To develop a potential quadriceps' index of complication evaluation for patients with chronic obstructive pulmonary disease (COPD) which is simple, convenient, and quantifiable.
We conducted a prospective study of 59 patients with COPD and 56 healthy controls recruited by the Chengdu First People's Hospital. Grayscale ultrasound (US) of the rectus femoris was performed to measure thickness (RF) and cross-sectional area (RF). Shear wave elastography was used to determine the mean elasticity index (SWE) of the rectus femoris (SWE), vastus lateralis (SWE) and vastus medialis (SWE). Clinical features included dyspnea index score (modified British Medical Research Council (MMRC) score), COPD Assessment Test (CAT), the Five-Repetition Sit-to-Stand Test (5STS) and the Six-Minute Walk Test (6MWT). We compared the differences between US parameters and SWEmean in healthy controls and COPD patients. We also described the correlation between US parameters, SWE and clinical features of patients with COPD.
The intra-observer repeatability for the performance of using SWE to measure quadriceps stiffness was excellent (intraclass correlation coefficient (ICC)>0.75, p < 0.001). There was a statistically significant difference in the SWE of the quadriceps (p < 0.001), but no significant difference in terms of RF and RF (p > 0.05) between healthy controls and COPD patients. The SWE was positively correlated with the 6MWT (r = 0.959, p < 0.001), and negatively related to the mMRC (r=-0.825, p < 0.001), CAT (r=-0.993, p < 0.001) and 5STS (r=-0.936, p < 0.001). However, the RF, RF, SWE and SWE were not correlated with clinical features (p > 0.05).
As a supplement to US, SWE reflects changes of stiffness in the quadriceps of COPD patients, and can expanding the dimension of US for assessing the quadriceps. Furthermore, SWE was associated with clinical features, and represents a potential index with which to reflect the clinical features of COPD patients.
开发一种用于评估慢性阻塞性肺疾病（COPD）患者并发症的潜在股四头肌指数，该指数简单、方便、可量化。
我们对 59 名 COPD 患者和 56 名健康对照者进行了前瞻性研究，这些患者均来自成都市第一人民医院。对股直肌进行灰阶超声（US）检查，测量厚度（RF）和横截面积（RF）。采用剪切波弹性成像技术测定股直肌（SWE）、股外侧肌（SWE）和股中间肌（SWE）的平均弹性指数（SWE）。临床特征包括呼吸困难指数评分（改良英国医学研究理事会（MMRC）评分）、COPD 评估测试（CAT）、五次重复坐立站起测试（5STS）和六分钟步行测试（6MWT）。我们比较了健康对照组和 COPD 患者之间 US 参数和 SWEmean 的差异。还描述了 US 参数、SWE 与 COPD 患者临床特征之间的相关性。
使用 SWE 测量股四头肌僵硬的观察者内重复性极好（组内相关系数（ICC）>0.75，p<0.001）。健康对照组和 COPD 患者之间的股四头肌 SWE 存在统计学差异（p<0.001），但 RF 和 RF 无显著差异（p>0.05）。SWE 与 6MWT 呈正相关（r=0.959，p<0.001），与 mMRC（r=-0.825，p<0.001）、CAT（r=-0.993，p<0.001）和 5STS（r=-0.936，p<0.001）呈负相关。然而，RF、RF、SWE 和 SWE 与临床特征无关（p>0.05）。
作为 US 的补充，SWE 反映了 COPD 患者股四头肌僵硬的变化，可以扩展 US 评估股四头肌的维度。此外，SWE 与临床特征相关，代表了一种潜在的反映 COPD 患者临床特征的指数。
