运动神经元病中上气道功能障碍的临床意义。
Clinical significance of upper airway dysfunction in motor neurone disease.
作者信息
García-Pachón E, Martí J, Mayos M, Casan P, Sanchis J
机构信息
Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Facultat de Medicina, Universitat Autonoma de Barcelona, Spain.
出版信息
Thorax. 1994 Sep;49(9):896-900. doi: 10.1136/thx.49.9.896.
BACKGROUND
To assess the occurrence, functional characteristics and prognostic value of upper airway dysfunction in motor neurone disease, 27 patients unselected for respiratory symptoms were studied.
METHODS
Upper airway function was evaluated by analysis of the maximal flow-volume loop. Neurological diagnosis was established from the clinical history and physical examination. The degree of impairment was quantified by the Appel score.
RESULTS
Twelve patients (group A) showed abnormalities of the maximal flow-volume loop consistent with flow limitation (seven patients) or instability of upper airway function (gross oscillations of airflow, five patients). The remaining 15 patients (group B) exhibited a normal or generally reduced maximal flow-volume loop, suggestive of muscle weakness. No differences were observed between groups in general physical condition, rate of disease progression, or duration of disease.
CONCLUSIONS
Upper airway dysfunction in patients with motor neurone disease was a frequent finding. It was present more often, but not exclusively, in patients with bulbar features and was unrelated to prognosis.
背景
为评估运动神经元病上气道功能障碍的发生率、功能特征及预后价值，对27例未因呼吸道症状而入选的患者进行了研究。
方法
通过分析最大流量-容积环评估上气道功能。根据临床病史和体格检查做出神经学诊断。采用阿佩尔评分对损伤程度进行量化。
结果
12例患者（A组）的最大流量-容积环异常，表现为流量受限（7例患者）或上气道功能不稳定（气流大幅振荡，5例患者）。其余15例患者（B组）的最大流量-容积环正常或普遍降低，提示肌肉无力。两组在一般身体状况、疾病进展速度或病程方面未观察到差异。
结论
运动神经元病患者中，上气道功能障碍很常见。在有延髓症状的患者中更常出现，但并非仅见于此类患者，且与预后无关。
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