Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Buyukdere Meselik Campus, Eskisehir Osmangazi University, 26040, Eskisehir, Turkey.
Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
Wien Klin Wochenschr. 2023 Oct;135(19-20):528-537. doi: 10.1007/s00508-023-02163-x. Epub 2023 Apr 3.
Diaphragmatic function can be affected in many diseases and disorders. Although systemic sclerosis (SSc) is a serious connective tissue disease that affects not only the skin but also the pulmonary and musculoskeletal systems, there is insufficient information about diaphragm function.
To compare the diaphragmatic parameters by ultrasonography (USG) in patients with SSc and healthy individuals and examine the relationship between these parameters and clinical features in patients with SSc.
This study included 13 patients with SSc and 15 healthy individuals. Muscle thickness (in deep inspiration T and at the end of calm expiration T), changes in thickness (∆T), and thickening fraction at deep breathing were evaluated by USG. Skin thickness, pulmonary function tests, respiratory muscle strength, and the perception of dyspnea were measured as clinical features.
The results of T T and ∆T were similar in both groups (p > 0.05), albeit patients in the SSc group had less thickening fraction compared to the control group (79.9 ± 36.7 cm and 103.8 ± 20.6 cm, respectively, p < 0.05). The T, ∆T, and thickening fraction of the diaphragm were associated with skin thickness, pulmonary function test parameters, and respiratory muscle strength (p < 0.05). Besides, there was significant correlation between muscle thickening fraction and perception of dyspnea (p < 0.05).
These results confirm that diaphragm thickness and contractility can be affected in patients with SSc. Therefore, ultrasonographic evaluation of the diaphragm can play a complementary role to pulmonary function test and respiratory muscle strength measurement in the diagnosis and follow-up of patients with SSc.
膈肌功能可能会受到许多疾病和障碍的影响。虽然系统性硬化症（SSc）是一种严重的结缔组织疾病，不仅会影响皮肤，还会影响肺部和肌肉骨骼系统，但关于膈肌功能的信息还不够充分。
通过超声（USG）比较 SSc 患者和健康个体的膈肌参数，并检查这些参数与 SSc 患者临床特征之间的关系。
本研究纳入了 13 例 SSc 患者和 15 名健康个体。通过 USG 评估膈肌的肌肉厚度（深吸气时 T 和平静呼气末 T）、厚度变化（∆T）和深呼吸时的增厚分数。测量皮肤厚度、肺功能测试、呼吸肌力量和呼吸困难的感知作为临床特征。
两组的 T T 和 ∆T 结果相似（p>0.05），但 SSc 组的增厚分数低于对照组（分别为 79.9±36.7cm 和 103.8±20.6cm，p<0.05）。膈肌的 T、∆T 和增厚分数与皮肤厚度、肺功能测试参数和呼吸肌力量相关（p<0.05）。此外，肌肉增厚分数与呼吸困难的感知之间存在显著相关性（p<0.05）。
这些结果证实 SSc 患者的膈肌厚度和收缩力可能受到影响。因此，超声评估膈肌可以在 SSc 患者的诊断和随访中发挥补充作用，与肺功能测试和呼吸肌力量测量相结合。
