摘要
目的 探讨外周血单个核细胞线粒体功能与慢性阻塞性肺疾病急性加重期(AECOPD)合并膈肌功能障碍的相关性。方法 选择2020年1月至2021年8月我院收治的115例AECOPD患者,41例发生膈肌功能障碍(障碍组),74例未发生膈肌功能障碍(无障碍组)。检测外周血单个核细胞线粒体呼吸控制率(RCR)、三磷酸腺苷酶(ATP)、膜电位吸光度差,并进行肺功能、呼吸力学、胸部B超检查。结果 障碍组RCR、ATP低于无障碍组(P<0.05),膜电位吸光度差高于无障碍组(P<0.05)。AECOPD患者RCR、ATP与FEV_(1)、FVC、MIP、Pdi、Pdi_(max)、膈神经刺激诱导Pdi、膈神经刺激诱导Pdi_(max)、功能残气位膈肌厚度、膈肌厚度变异率、膈肌移动度呈正相关(P<0.05),与TTdi呈负相关(P<0.05);膜电位吸光度差则相反(P<0.05)。联合RCR、膜电位吸光度差、ATP诊断膈肌功能障碍的曲线下面积为0.898(P<0.05)。结论 外周血单核细胞线粒体RCR、ATP降低,膜电位吸光度差增高与AECOPD患者通气功能下降,膈肌疲劳、厚度减少和运动力降低有关。
Objective To investigate the relationship between the mitochondrial function of peripheral blood mononuclear cells and diaphragm dysfunction in acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 115 patients with AECOPD admitted to our hospital from January 2020 to August 2021 were selected, including 41 patients with diaphragmatic dysfunction(disorder group) and 74 patients without diaphragmatic dysfunction(barrier-free group). The mitochondrial respiratory control rate(RCR), adenosine triphosphate(ATP), and membrane potential absorbance difference of peripheral blood mononuclear cells were detected. Lung function, respiratory mechanics, and chest B ultrasound were performed. Results The RCR and ATP in the disorder group were lower than the barrier-free group(P<0.05), and the membrane potential absorbance difference was higher than that of the barrier-free group(P<0.05). In AECOPD patients, RCR and ATP were positively correlated with FEV_(1), FVC, MIP, Pdi, Pdi_(max), phrenic nerve stimulation-induced Pdi, phrenic nerve stimulation-induced Pdi_(max), diaphragm thickness of functional residual gas level, the variation rate of diaphragm thickness, and diaphragm mobility(P<0.05), and negatively correlated with TTdi(P<0.05), but the membrane potential absorbance difference was opposite(P<0.05). The area under the curve combined with RCR, ATP, and membrane potential absorbance for diagnosing diaphragm dysfunction in AECOPD patients was 0.898(P<0.05). Conclusion The decrease of mitochondrial RCR and ATP in peripheral blood mononuclear cells and the increase of membrane potential difference are related to the decrease in ventilation function, diaphragm fatigue, thickness, and motor power in patients with AECOPD.
作者
杨宁梅
阳元彬
杜凤
罗凤华
YANG Ning-mei;YANG Yuan-bin;DU Feng;LUO Feng-hua(Second Clinical Medical College of North Sichuan Medical College,Nanchong Central Hospital,Nanchong,Sichuan 637000,China)
出处
《临床肺科杂志》
2023年第1期48-53,共6页
Journal of Clinical Pulmonary Medicine
关键词
单个核细胞线粒体功能
膈肌功能障碍
慢性阻塞性肺疾病急性加重期
Mitochondrial function of mononuclear cells
Diaphragmatic dysfunction
Acute exacerbation of chronic obstructive pulmonary disease
