摘要
目的探讨COPD患者股四头肌肌力下降的特点及其功能测试的方法。方法对2007年6月至10月在广州呼吸疾病研究所门诊的71例（男54例，女17例）COPD稳定期患者（COPD组）和同期广州医学院第一附属医院体检中心的60名（男21名，女39名）老年健康体检者（对照组）常规进行肺通气功能测定、人体学测量和日常活动评分。股四头肌功能测试包括最大主动收缩力（QMVC）、耐力以及最大磁刺激强度时的肌颤搐张力。应用SPSS12．0软件进行统计学分析。计量资料以x±s表示，组间比较采用成组设计t检验，分级后组间比较采用单因素方差分析，组间两两比较采用q检验。各指标间采用线性相关分析，P〈0．05为差异有统计学意义。结果COPD组男性的QMVC、耐力和肌颤搐张力分别为（23±6）kg、（51±18）s和（7．0±2．3）kg，明显低于对照组男性的（42±8）kg、（81±27）s和（13．9±6．7）kg（t值为5．89—10．73，均P〈0．01）；COPD组女性的QMVC、耐力和肌颤搐张力分别为（16±4）kg、（56±8）s和（4．2±0．9）kg，明显低于对照组女性的（29±5）kg、（83±32）s和（7．4±2．1）kg（t值为3．47—9．35，均P〈0．01）。COPD组的QMVC与FEV1、体重指数和股部肌肉周径均呈显著正相关（r值为0．27～0．76，均P〈0．01）。结论COPD患者的股四头肌收缩力和耐力均明显下降，以QMVC下降更为明显，且与肺功能气流阻塞程度呈正相关。肌颤搐张力可客观评价股四头肌肌力的变化，采用肌颤搐张力与QMVC和耐力3项指标相结合，可以提高检测结果的准确性。
Objective To investigate the quadriceps strength in patients with stable chronic obstructive pulmonary disease（ COPD）, and the characteristics of quadriceps dysfunction in COPD patients. Methods All participants including 71 （ male 54, female 17 ） patients with stable COPD and 60 （ male 21, female 39 ） normal subjects underwent lung function tests, anthropemetric measurements, quadriceps function assessments and physical activities evaluation. Quadriceps function was assessed by measurement of the maximal isometric volitional contraction （QMVC）, endurance time and the maximal twitch tension. SPSS 12.0 was used to perform statistics. The results were presented as the x±s for all variables that were normally distributed. Differences between the two groups （ i. e. , patients vs. controls） were analyzed using a two-tailed grouped t test. Differences between the groups within the COPD patients were analyzed using oneway ANOVA, and q-test was used to analyze the differences between them. Linear regression analysis was used to investigate the relationships between variables. Results The mean QMVC was （42 ± 8 ） kg, endurance time was （81 ± 27 ） s, the maximal twitch tension was （13.9 ± 6. 7 ） kg in normal men, while they were （23 ±6） kg, （51 ± 18） s and （7.0±2. 3） kg respectively in their COPD counterparts （t value was 5. 89 - 10. 73, all P 〈 0. 01 ）. The mean QMVC was （29 ± 5） kg, endurance time was （83 ± 32） s and the maximal twitch tension was （7.4 ±2. 1） kg in normal female subjects, while they were （16±4） kg, （56± 8） s and （4. 2 ± 0. 9） kg respectively in female COPD patients （ t value was 3.47 - 9. 35, all P 〈 0. 01 ）. Correlation analysis showed that QMVC positively correlated with lung function variables, body mass index and mid-thigh muscle circumference in COPD patients （ r value was 0. 27 - 0. 76, all P 〈 0. 01 ）. Conclusions Our data showed that quadriceps dysfunction was common in COPD patients. QMVC was impaired to a greater extent than isometric endurance, and QMVC positively correlated with the severity of airflow obstruction. The maximal twitch tension induced by magnetic femoral nerve stimulation was an objective method to assess quadriceps strength.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2008年第8期566-570,共5页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
肺疾病
慢性阻塞性
四头肌
肌力
Pulmonary disease, chronic obstructive
Quadriceps muscle
Muscle strength
