Almenoff P L, Spungen A M, Lesser M, Bauman W A
Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA.
Lung. 1995;173(5):297-306. doi: 10.1007/BF00176893.
Spirometry was performed on 165 subjects with spinal cord injury (84 with quadriplegia and 81 with paraplegia). Subjects were characterized by level of lesion as: high quadriplegia (HQ, C4 and above not requiring mechanical ventilation), low quadriplegia (LQ, C5-8), high paraplegia (HP, T1-7), and low paraplegia (LP, T8-L3). Thirty-nine subjects had complete motor lesions, and 126 had incomplete motor lesions. Nonsmokers (54 with quadriplegia and 53 with paraplegia) were defined as those who had never smoked or those who had stopped smoking for 1 year. Current smokers (28 with quadriplegia and 28 with paraplegia) were defined as those who currently smoked cigarettes, cigars, and/or pipe or those who had quit for < or = 1 year. We found by linear regression analysis that forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV) were inversely correlated with the level of injury (i.e., the higher the level of injury, the lower the parameter). In the HQ group, those with complete injury had significantly lower pulmonary function parameters than those with incomplete lesions. In contrast, there were no significant differences in pulmonary function parameters between complete and incomplete lesions in subjects in the LQ, HP, and LP groups. In the LQ, HP, and LP groups, the FEV1 and PEF were significantly lower in smokers than in nonsmokers. Thus, this study demonstrates the effects of completeness of injury and smoking on pulmonary function in a large group of subjects with spinal cord injury.
对165例脊髓损伤患者（84例四肢瘫痪和81例截瘫）进行了肺功能测定。根据损伤平面将患者分为：高位四肢瘫痪（HQ，C4及以上且无需机械通气）、低位四肢瘫痪（LQ，C5 - 8）、高位截瘫（HP，T1 - 7）和低位截瘫（LP，T8 - L3）。39例患者有完全性运动损伤，126例有不完全性运动损伤。非吸烟者（54例四肢瘫痪和53例截瘫）定义为从未吸烟或已戒烟1年者。当前吸烟者（28例四肢瘫痪和28例截瘫）定义为目前吸香烟、雪茄和/或烟斗者或戒烟≤1年者。通过线性回归分析，我们发现用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、呼气峰值流速（PEF）和最大自主通气量（MVV）与损伤平面呈负相关（即损伤平面越高，参数越低）。在高位四肢瘫痪组中，完全损伤患者的肺功能参数显著低于不完全损伤患者。相比之下，低位四肢瘫痪组、高位截瘫组和低位截瘫组患者中，完全损伤和不完全损伤患者的肺功能参数无显著差异。在低位四肢瘫痪组、高位截瘫组和低位截瘫组中，吸烟者的FEV1和PEF显著低于非吸烟者。因此，本研究证明了损伤完整性和吸烟对一大组脊髓损伤患者肺功能的影响。
