计算机断层扫描定量呼吸肌与慢性阻塞性肺疾病的关系：一项回顾性研究。
Association between computed tomography-quantified respiratory muscles and chronic obstructive pulmonary disease: a retrospective study.
机构信息
Department of Infectious Diseases, Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China.
Guangzhou Chest Hospital, Guangzhou, China.
出版信息
BMC Pulm Med. 2024 Mar 21;24(1):150. doi: 10.1186/s12890-024-02955-5.
BACKGROUND
This study examined the association between chest muscles and chronic obstructive pulmonary disease (COPD) and the relationship between chest muscle areas and acute exacerbations of COPD (AECOPD).
METHODS
There were 168 subjects in the non-COPD group and 101 patients in the COPD group. The respiratory and accessory respiratory muscle areas were obtained using 3D Slicer software to analysis the imaging of computed tomography (CT). Univariate and multivariate Poisson regressions were used to analyze the number of AECOPD cases during the preceding year. The cutoff value was obtained using a receiver operating characteristic (ROC) curve.
RESULTS
We scanned 6342 subjects records, 269 of which were included in this study. We then measured the following muscle areas (non-COPD group vs. COPD group): pectoralis major (19.06 ± 5.36 cm vs. 13.25 ± 3.71 cm, P < 0.001), pectoralis minor (6.81 ± 2.03 cm vs. 5.95 ± 1.81 cm, P = 0.001), diaphragmatic dome (1.39 ± 0.97 cm vs. 0.85 ± 0.72 cm, P = 0.011), musculus serratus anterior (28.03 ± 14.95 cm vs.16.76 ± 12.69 cm, P < 0.001), intercostal muscle (12.36 ± 6.64 cm vs. 7.15 ± 5.6 cm, P < 0.001), pectoralis subcutaneous fat (25.91 ± 13.23 cm vs. 18.79 ± 10.81 cm, P < 0.001), paravertebral muscle (14.8 ± 4.35 cm vs. 13.33 ± 4.27 cm, P = 0.007), and paravertebral subcutaneous fat (12.57 ± 5.09 cm vs. 10.14 ± 6.94 cm, P = 0.001). The areas under the ROC curve for the pectoralis major, intercostal, and the musculus serratus anterior muscle areas were 81.56%, 73.28%, and 71.56%, respectively. Pectoralis major area was negatively associated with the number of AECOPD during the preceding year after adjustment (relative risk, 0.936; 95% confidence interval, 0.879-0.996; P = 0.037).
CONCLUSION
The pectoralis major muscle area was negative associated with COPD. Moreover, there was a negative correlation between the number of AECOPD during the preceding year and the pectoralis major area.
背景
本研究旨在探讨胸肌与慢性阻塞性肺疾病（COPD）的关系，以及胸肌面积与 COPD 急性加重（AECOPD）的关系。
方法
非 COPD 组 168 例，COPD 组 101 例。使用 3D Slicer 软件获得呼吸和辅助呼吸肌面积，分析 CT 影像学。采用单因素和多因素 Poisson 回归分析前一年 AECOPD 发病例数。采用受试者工作特征（ROC）曲线获得截断值。
结果
我们扫描了 6342 例患者的记录，其中 269 例纳入本研究。然后测量了以下肌肉面积（非 COPD 组与 COPD 组）：胸大肌（19.06±5.36cm 比 13.25±3.71cm，P<0.001）、胸小肌（6.81±2.03cm 比 5.95±1.81cm，P=0.001）、膈肌穹隆（1.39±0.97cm 比 0.85±0.72cm，P=0.011）、前锯肌（28.03±14.95cm 比 16.76±12.69cm，P<0.001）、肋间肌（12.36±6.64cm 比 7.15±5.6cm，P<0.001）、胸肌皮下脂肪（25.91±13.23cm 比 18.79±10.81cm，P<0.001）、椎旁肌（14.8±4.35cm 比 13.33±4.27cm，P=0.007）和椎旁皮下脂肪（12.57±5.09cm 比 10.14±6.94cm，P=0.001）。胸大肌、肋间肌和前锯肌面积的 ROC 曲线下面积分别为 81.56%、73.28%和 71.56%。胸大肌面积与前一年 AECOPD 发病例数呈负相关（调整后相对危险度为 0.936；95%置信区间为 0.879-0.996；P=0.037）。
结论
胸大肌面积与 COPD 呈负相关。此外，前一年 AECOPD 发病例数与胸大肌面积呈负相关。
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