Impairment of respiratory muscle function in pulmonary hypertension
Impairment of respiratory muscle function in pulmonary hypertension
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DOI：
10.1042/cs20070238
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发表时间：
2008-01-01
期刊：
影响因子：
6
通讯作者：
Windisch, Wolfram
中科院分区：
文献类型：
--
作者：
Kabitz, Hans-Joachim;Schwoerer, Anja;Windisch, Wolfram
已有研究表明，肺高压患者的呼吸肌功能受损；然而，对呼吸肌功能的全面调查，包括应用非意志性测试，以证实肺高压患者的呼吸肌力量受损，尚未进行。在本研究中，对31例PH患者(20名女性和11名男性；平均肺动脉压51+/-20毫米汞柱；世界卫生组织中位数3.0+/-0.5级；25名肺动脉高压患者和6名慢性血栓栓塞性PH患者)和31名性别、年龄和体重指数(BMI)匹配的对照组(20名女性和1名男性)进行了呼吸肌功能的评估。进行6分钟步行试验，以确定运动能力。自愿评估最大吸气压(7.5kPa7.5+/-2.1vs6.2+/-2.8kpa；P=0.04)和呼气压(13.3+/-4.2vs9.9+/-3.4kpa；P<；0.001)，鼻腔(8.3+/-1.9vs6.6+/-2.2kPa.P=0.002)和跨膈(11.3+/-2.5vs8.7+/-2.5kpa；P<；与对照组相比，PH患者双侧前膈神经磁刺激时的压力、非主观评估的痉挛口压(1.46±/-0.43比0.97+/-0.41 kPaP<；0.00 1)和跨膈压(2.08±/-0.55比1.47+/-0.72 kPa；P=0.00 1)均显著降低。PH患者最大吸气口压力(r=0.58，P<；0.00 1)和跨膈嗅压(r=0.43，P=0.02)与6min步行距离相关。总之，目前的研究提供了强有力的证据表明，与匹配良好的对照组受试者相比，肥厚症患者的呼吸肌力量减弱。此外，6分钟的步行距离与评估吸气肌力的参数显著相关。
It has been suggested that impaired respiratory muscle function occurs in patients with PH (pulmonary hypertension); however, comprehensive investigations of respiratory muscle function, including the application of non-volitional tests, needed to verify impairment of respiratory muscle strength in patients with PH have not yet been performed. In the present study, respiratory muscle function was assessed in 31 patients with PH (20 females and 11 males; mean pulmonary artery pressure, 51 +/- 20 mmHg; median World Health Organization class 3.0 +/- 0.5; 25 patients with pulmonary arterial hypertension and six patients with chronic thromboembolic PH) and in 31 control subjects (20 females and I I males) well-matched for gender, age and BMI (body mass index). A 6-min walking test was performed to determine exercise capacity. Volitionally assessed maximal inspiratory (7.5 +/- 2.1 compared with 6.2 +/- 2.8 kPa; P = 0.04) and expiratory (13.3 +/- 4.2 compared with 9.9 +/- 3.4 kPa; P < 0.001) mouth pressures, sniff nasal (8.3 +/- 1.9 compared with 6.6 +/- 2.2 kPa; P = 0.002) and transdiaphragmatic (11.3 +/- 2.5 compared with 8.7 +/- 2.5 kPa.; P < 0.00 1) pressures, non-volitionally assessed twitch mouth (1.46 +/- 0.43 compared with 0.97 +/- 0.41 kPa; P < 0.00 1) and transdiaphragmatic (2.08 +/- 0.55 compared with 1.47 +/- 0.72 kPa; P = 0.00 1) pressures during bilateral anterior magnetic phrenic nerve stimulation were markedly lower in patients with PH compared with control subjects. Maximal inspiratory mouth (r = 0.58, P < 0.00 1) and sniff transdiaphragmatic (r = 0.43, P = 0.02) pressures were correlated with the 6-min walking distance in patients with PH. In conclusion, the present study provides strong evidence that respiratory muscle: strength is reduced in patients with PH compared with well-matched control subjects. Furthermore, the 6-min walking distance is significantly linked to parameters assessing inspiratory muscle strength.