Assessment of asynchronous and paradoxic motion between rib cage and abdomen in normal subjects and in patients with chronic obstructive pulmonary disease.

Assessment of asynchronous and paradoxic motion between rib cage and abdomen in normal subjects and in patients with chronic obstructive pulmonary disease.
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DOI：
10.1164/arrd.1984.130.4.588
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发表时间：
2015-05
期刊：
The American review of respiratory disease
影响因子：
--
通讯作者：
M. Sackner;H. Gonzalez;M. Rodríguez;A. Belsito;D. R. Sackner;S. Grenvik
M. Sackner;H. Gonzalez;M. Rodríguez;A. Belsito;D. R. Sackner;S. Grenvik
中科院分区：
其他
文献类型：
--
作者：
M. Sackner;H. Gonzalez;M. Rodríguez;A. Belsito;D. R. Sackner;S. Grenvik

文献摘要

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分析胸腔 (RC) 和腹部 (AB) 偏移的标量追踪和 XY 图，以检测一个隔室相对于另一个隔室的异步和/或矛盾运动，以区分正常受试者和慢性阻塞性肺疾病 (COPD) 患者之间的差异。吸气异步指数（IAI）是通过连接RC-AB环从吸气开始到吸气结束的直线，并将吸气部分包围的面积除以潮气量得到的。以类似的方式，计算呼气异步指数（EAI）。 COPD 患者仰卧位的 IAI 和 EAI 值高于正常受试者，并且这种差异在自然和自主控制的腹式呼吸中得到一致证明。当 RC 或 AB 室沿与两者总和相反的方向移动时，表示反常运动为吸气和呼气室偏移的体积或时间段的百分比。在自然呼吸期间，正常受试者几乎不存在反常运动，而慢性阻塞性肺病患者则不同程度地存在反常运动。自主控制的呼吸模式会增加 IAI、EAI 和矛盾运动。从仰卧位到直立位的被动倾斜不会影响正常受试者的指标，但会减少 COPD 患者 RC 的异步和反常运动。循环分析的其他指标，例如相位角和最大隔室振幅/潮气量，在自然和自主控制呼吸模式下区分正常受试者和 COPD 患者时并不一致。（摘要截断为 250 字）
Both scalar tracings and XY plots of rib cage (RC) and abdominal (AB) excursions were analyzed to detect asynchronous and/or paradoxic motion of one compartment with respect to the other in an effort to distinguish differences between normal subjects and patients with chronic obstructive pulmonary disease (COPD). An inspiratory asynchrony index (IAI) was obtained by connecting a straight line from beginning inspiration to end inspiration of the RC-AB loop, and dividing the area enclosed by the inspiratory portion by the tidal volume. In like manner, an expiratory asynchrony index (EAI) was computed. Values of IAI and EAI in the supine posture were greater in patients with COPD than in normal subjects, and such differences were consistently demonstrated during natural and voluntarily controlled abdominal breathing. Paradoxic motion as percent of volume or time period of inspiratory and expiratory compartmental excursions was indicated when RC or AB compartments moved in an opposite direction to the sum of the two. During natural breathing, paradoxic motion was almost absent in normal subjects and variably present in patients with COPD. Voluntarily controlled breathing patterns produced increased IAI, EAI, and paradoxic motion. Passive tilting from supine to the upright posture did not affect indexes in normal subjects but reduced asynchronous and paradoxic motion of the RC in patients with COPD. Other indexes of loop analysis, such as phase angle and maximal compartment amplitude/tidal volume, were not as consistent in distinguishing between normal subjects and patients with COPD during natural and voluntarily controlled breathing patterns.(ABSTRACT TRUNCATED AT 250 WORDS)