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稳定期慢性阻塞性肺疾病患者握力与气体陷闭的相关性

Correlation between handgrip strength and air trapping in patients with stable chronic obstructive pulmonary disease.

作者信息

Saiphoklang Narongkorn, Tirakitpanich Kritti

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.

Department of Medicine, Thammasat University Hospital, Pathum Thani, Thailand.

出版信息

J Thorac Dis. 2024 Sep 30;16(9):5634-5642. doi: 10.21037/jtd-24-631. Epub 2024 Aug 30.

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) often presents with dyspnea resulting from the condition of air trapping, assessed by lung volume measurement studies. This study aimed to investigate the relationship between handgrip strength (HGS) and air trapping in COPD patients.

METHODS

Cross-sectional research was conducted in COPD patients at Thammasat University Hospital, Thailand between May 2022 and December 2023. HGS was assessed using the Jamar Smart Hand Dynamometer, and air trapping was measured using a body plethysmograph. Air trapping was defined as a ratio of residual volume (RV) to total lung capacity (TLC) greater than 40%. Receiver operator characteristic (ROC) curves, sensitivity, and specificity values were calculated to determine the optimal cutoff value of HGS for predicting air trapping.

RESULTS

A total of 72 patients (90.3% male) were included, with an average age of 72.4±9.7 years. The body mass index was 23.5±4.3 kg/m. The smoking history was 23.2±14.8 pack-years. Common comorbidities included hypertension (36.1%) and diabetes (22.2%). Post-bronchodilator forced expiratory volume in 1 second (FEV1) was 72.1%±21.2%. Air trapping was found in 55.6%. A negative correlation was found between HGS and RV/TLC (R=-0.399, P=0.001). The best cutoff value for HGS to predict air trapping was 28.3 kg, with 71.9% sensitivity and 65.0% specificity. The area under the ROC curve for identifying air trapping was 0.681 (95% CI: 0.554 to 0.808, P=0.009).

CONCLUSIONS

Air trapping is common in COPD patients, and HGS is significantly correlated with air trapping. Thus, HGS may serve as an alternative tool for assessing air trapping.

摘要

背景

慢性阻塞性肺疾病(COPD)常因气体潴留导致呼吸困难,通过肺容积测量研究进行评估。本研究旨在调查COPD患者握力(HGS)与气体潴留之间的关系。

方法

2022年5月至2023年12月期间,在泰国法政大学医院对COPD患者进行了横断面研究。使用Jamar智能握力计评估HGS,使用体容积描记器测量气体潴留。气体潴留定义为残气量(RV)与肺总量(TLC)之比大于40%。计算受试者工作特征(ROC)曲线、敏感性和特异性值,以确定预测气体潴留的HGS最佳截断值。

结果

共纳入72例患者(90.3%为男性),平均年龄为72.4±9.7岁。体重指数为23.5±4.3kg/m。吸烟史为23.2±14.8包年。常见合并症包括高血压(36.1%)和糖尿病(22.2%)。支气管扩张剂后1秒用力呼气容积(FEV1)为72.1%±21.2%。发现55.6%的患者存在气体潴留。HGS与RV/TLC之间存在负相关(R=-0.399,P=0.001)。预测气体潴留的HGS最佳截断值为28.3kg,敏感性为71.9%,特异性为65.0%。识别气体潴留的ROC曲线下面积为0.681(95%CI:0.554至0.808,P=0.009)。

结论

气体潴留在COPD患者中很常见,HGS与气体潴留显著相关。因此,HGS可作为评估气体潴留的替代工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/232b/11494569/5cbbfd9a4832/jtd-16-09-5634-f1.jpg

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