Balance impairment and systemic inflammation in chronic obstructive pulmonary disease
Balance impairment and systemic inflammation in chronic obstructive pulmonary disease
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慢性阻塞性肺疾病的平衡障碍和全身炎症
DOI：
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
B. Timar
中科院分区：
文献类型：
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作者：
E. Tudorache;C. Oancea;C. Avram;O. Fira;L. Petrescu;B. Timar
背景/目的慢性阻塞性肺疾病（COPD），尤其是严重的COPD，通常伴有全身炎症和平衡障碍。本研究的目的是评估COPD稳定期和急性加重期（COPD急性加重期[AECOPD]）对平衡的影响，并研究下肢肌无力和全身炎症之间是否存在联系。方法选择41例COPD患者（稳定期22例，AECOPD 19例）和20例健康体检者（对照组），两组患者的人体测量数据差异无统计学意义。我们分析了这些组之间平衡测试评分的差异：福尔斯疗效量表-国际（FES-I）问卷、贝格平衡量表（BBS）、定时起身和行走（TUG）测试、单腿站立（SLS）、6分钟步行距离（6 MWD）、等长膝关节伸展（IKE），以及这些评分与炎症生物标志物之间的相关性。结果COPD的存在和严重程度与IKE（P<0.001）、6 MWD（P<0.001）、SLS（P<0.001）和BBS（P<0.001）评分显著降低相关，同时注意到研究组中位TUG评分显著增加（P<0.001）。AECOPD组与稳定组相比，高敏C反应蛋白（hs-CRP）水平显著升高（10.60 vs 4.01; P=0.003），PaO 2显著降低（70.1 vs 59.1; P<0.001）。我们观察到两个IKE评分均与所有呼吸量呈显着正相关。两组中纤维蛋白原与6 MWD呈显著正相关，FES-I问卷与TUG试验呈正相关。hs-CRP与步行试验、SLS试验呈显著正相关，与TUG试验、FES-I问卷呈正相关。结论慢性阻塞性肺疾病急性加重期患者福尔斯史、全身炎症、平衡功能障碍、下肢肌无力的发生率增高。
Background/purpose Chronic obstructive pulmonary disease (COPD), especially in severe forms, is commonly associated with systemic inflammation and balance impairment. The aim of our study was to evaluate the impact on equilibrium of stable and exacerbation (acute exacerbation of COPD [AECOPD]) phases of COPD and to investigate if there is a connection between lower extremity muscle weakness and systemic inflammation. Methods We enrolled 41 patients with COPD (22 stable and 19 in AECOPD) and 20 healthy subjects (control group), having no significant differences regarding the anthropometric data. We analyzed the differences in balance tests scores: Falls Efficacy Scale-International (FES-I) questionnaire, Berg Balance Scale (BBS), Timed Up and Go (TUG) test, Single Leg Stance (SLS), 6-minute walking distance (6MWD), isometric knee extension (IKE) between these groups, and also the correlation between these scores and inflammatory biomarkers. Results The presence and severity of COPD was associated with significantly decreased score in IKE (P<0.001), 6MWD (P<0.001), SLS (P<0.001), and BBS (P<0.001), at the same time noting a significant increase in median TUG score across the studied groups (P<0.001). The AECOPD group vs stable group presented a significant increase in high-sensitive C-reactive protein (hs-CRP) levels (10.60 vs 4.01; P=0.003) and decrease in PaO2 (70.1 vs 59.1; P<0.001). We observed that both IKE scores were significantly and positive correlated with all the respiratory volumes. In both COPD groups, we observed that fibrinogen reversely and significantly correlated with the 6MWD, and FES-I questionnaire is correlated positively with TUG test. Hs-CRP correlated reversely with the walking test and SLS test, while correlating positively with TUG test and FES-I questionnaire. Conclusion According to this study, COPD in advanced and acute stages is associated with an increased history of falls, systemic inflammation, balance impairment, and lower extremity muscle weakness.