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超声测量原发性营养不良小儿的膈肌厚度。

Diaphragm thickness by ultrasound in pediatric patients with primary malnutrition.

机构信息

Department of Pediatric Gastroenterology, School of Medicine, Kahramanmaras Sütcü İmam University, Kahramanmaras, Turkey.

Department of Radiology, School of Medicine, Kahramanmaras Sütcü İmam University, 46010, Kahramanmaras, Turkey.

出版信息

Eur J Pediatr. 2023 Jul;182(7):3347-3354. doi: 10.1007/s00431-023-05024-x. Epub 2023 May 13.

Abstract

Skeletal muscle atrophy is known to be a marker for nutritional deficiency. The diaphragm is both a skeletal muscle and a respiratory muscle. There is not enough data in the literature about the change in diaphragm thickness (DT) in children with malnutrition. We think that malnutrition may have negative effects on diaphragm thickness. Therefore, in this study, we aimed to compare the diaphragm thicknesses of pediatric patients with primary malnutrition and a healthy control group. The DT of pediatric patients diagnosed with primary malnutrition by a pediatric gastroenterologist was prospectively evaluated by a radiology specialist by ultrasonography (USG). The obtained data were statistically compared with the data of the healthy control group. There was no statistically significant difference between the groups in terms of age and gender (p = 0.244, p = 0.494). We found that right and left diaphragm thicknesses were significantly thinner in the malnourished group than in the healthy control group (p = 0.001, p = 0.009, respectively). We found that right and left diaphragm thicknesses were thinner in those with moderate and severe malnutrition compared to the normal group (p < 0.001, p = 0.003, respectively). We found a significant weak positive correlation between weight and height Z score and right and left diaphragm thickness (respectively, r: 0.297, p < 0.001; r: 0.301, p < 0.001).   Conclusion: Malnutrition is a disease that affects all systems. Our study shows that the DT is thinner in patients with malnutrition. What is Known: •Malnutrition causes skeletal muscle atrophy. What is New: •Diaphragm muscle thickness decreases in malnutrition. •There is a significant positive correlation between diaphragm muscle thickness and height, weight and BMI z scores.

摘要

肌肉萎缩是营养不良的标志。横膈膜既是骨骼肌也是呼吸肌。关于营养不良儿童膈肌厚度(DT)变化的文献数据不足。我们认为营养不良可能对膈肌厚度有负面影响。因此,在这项研究中,我们旨在比较原发性营养不良的儿科患者和健康对照组的膈肌厚度。儿科胃肠病学家诊断为原发性营养不良的儿科患者的 DT 通过放射科专家的超声(USG)进行前瞻性评估。通过统计学方法将获得的数据与健康对照组的数据进行比较。在年龄和性别方面,两组之间没有统计学差异(p=0.244,p=0.494)。我们发现,营养不良组的右侧和左侧膈肌厚度明显比健康对照组薄(分别为 p=0.001,p=0.009)。我们发现,中度和重度营养不良患者的右侧和左侧膈肌厚度比正常组薄(分别为 p<0.001,p=0.003)。我们发现体重和身高 Z 评分与右侧和左侧膈肌厚度之间存在显著的弱正相关(分别为 r:0.297,p<0.001;r:0.301,p<0.001)。结论:营养不良是一种影响全身的疾病。我们的研究表明,营养不良患者的膈肌厚度较薄。已知:•营养不良导致骨骼肌萎缩。新发现:•膈肌厚度在营养不良中减少。•膈肌厚度与身高、体重和 BMI z 评分之间存在显著正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2001/10182341/b3f98f824228/431_2023_5024_Fig1_HTML.jpg

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