Pınar Deniz Pelin, Köse Sevgül, Hanta İsmail, Duru Çetinkaya Pelin, Arslan Merisa Sinem, Datlı Erolcan
Department of Respiratory Disease, Cukurova University Faculty of Medicine, Yüregir, Adana 01250, Turkey.
Department of Radiology, Cukurova University Faculty of Medicine, Yüregir, Adana 01250, Turkey.
Medicina (Kaunas). 2025 Jun 29;61(7):1181. doi: 10.3390/medicina61071181.
: Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive interstitial lung disease with an unknown etiology. It is often accompanied by skeletal muscle mass loss. Chest wall muscles play a crucial role in respiratory movements and form part of the skeletal muscles. The aim of this study is to evaluate the relationship between chest wall muscle thickness and pulmonary function test (PFT) results, as well as other prognostic markers, in patients with IPF. : A retrospective analysis was conducted on 108 patients diagnosed with IPF and 53 control subjects. Chest wall muscle thickness was measured on thoracic computed tomography (CT) images at specific anatomical levels. PFT parameters, the Gender-Age-Physiology (GAP) index, number of acute exacerbations, and mortality data were evaluated in relation to muscle thickness. : IPF patients had significantly reduced thickness in the bilateral external scapular muscles at both the aortic and pulmonary trunk levels compared to controls. Bilateral pectoral muscle thickness at the aortic level was positively correlated with forced vital capacity (FVC) and negatively correlated with the number of exacerbations. Internal scapular muscle thickness at the aortic level showed a significant positive correlation with diffusion capacity of the lung for carbon monoxide (DLCO) and a negative correlation with both GAP scores and exacerbation frequency. External scapular muscle thickness at the pulmonary trunk level was positively associated with PFT parameters and inversely correlated with the GAP index, exacerbations, and mortality. : In patients with IPF, the bilateral external scapular muscle thickness at the aortic and pulmonary trunk levels was significantly reduced compared to controls. Significant associations were found between some chest wall muscle thicknesses and the GAP index, pulmonary function, acute exacerbations, and mortality, underscoring the prognostic value of baseline muscle measurements. Measurement of chest wall muscle thickness using routine thoracic CT scans may offer additional prognostic value in IPF. Incorporating this parameter into clinical evaluation may help identify patients who could benefit from supportive interventions, such as nutritional therapy or pulmonary rehabilitation.
特发性肺纤维化(IPF)是一种病因不明的慢性进行性间质性肺疾病的特殊形式。它常伴有骨骼肌质量丢失。胸壁肌肉在呼吸运动中起关键作用,是骨骼肌的一部分。本研究的目的是评估IPF患者胸壁肌肉厚度与肺功能测试(PFT)结果以及其他预后指标之间的关系。
对108例诊断为IPF的患者和53例对照者进行了回顾性分析。在胸部计算机断层扫描(CT)图像上的特定解剖层面测量胸壁肌肉厚度。评估PFT参数、性别-年龄-生理学(GAP)指数、急性加重次数和死亡率数据与肌肉厚度的关系。
与对照组相比,IPF患者在主动脉和肺动脉干水平的双侧肩胛下肌厚度明显降低。主动脉水平的双侧胸肌厚度与用力肺活量(FVC)呈正相关,与加重次数呈负相关。主动脉水平的肩胛内肌厚度与肺一氧化碳弥散量(DLCO)呈显著正相关,与GAP评分和加重频率均呈负相关。肺动脉干水平的肩胛下肌厚度与PFT参数呈正相关,与GAP指数、加重次数和死亡率呈负相关。
在IPF患者中,与对照组相比,主动脉和肺动脉干水平的双侧肩胛下肌厚度明显降低。发现一些胸壁肌肉厚度与GAP指数、肺功能、急性加重次数和死亡率之间存在显著关联,强调了基线肌肉测量的预后价值。使用常规胸部CT扫描测量胸壁肌肉厚度可能为IPF提供额外的预后价值。将该参数纳入临床评估可能有助于识别那些可能从支持性干预措施(如营养治疗或肺康复)中获益的患者。