Pulmonary Function and Respiratory Muscle Strength in Mild to Moderate Adolescent Idiopathic Scoliosis Patients
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摘要:
目的 探究青少年特发性脊柱侧弯患者（adolescent idiopathic scoliosis，AIS）对比同龄健康人肺功能与呼吸肌力的相关指标，并研究侧弯角度的大小和侧弯类型与AIS患者肺功能和呼吸肌力的相关性。 方法 分析2022年6月至12月在昆明医科大学第二附属医院骨科的50名AIS患者[Cobb = （29.720±11.875）]和50名健康青少年的肺功能指标，指标包括：用力肺活量占预计值百分数（FVC pred%）、第1秒最大呼气容积占预计值百分数（FEV1 pred%）、最大呼气流速占预计值百分数（PEF pred%）、FEV1 /FVC占正常预计值的百分比（ FEV1/FVC% pred）；呼吸肌功能指标：最大呼气压力（MEP）、最大吸气压力（MIP）。 结果 AIS组和健康对照组的FEV1/FVC、PEF pred%差异无统计学意义（P > 0.05），AIS组FVC pred%、FEV1 pred%、吸气肌力和呼气肌力差于健康组（ P < 0.01）。肺功能参数、呼吸肌力与Cobb角之间没有相关性，不同侧弯类型患者之间的肺功能和呼吸肌力差异无统计学意义（ P > 0.05）。 结论 AIS患者的FVC pred%和FEV1 pred%，及呼吸肌力差于同年龄健康人，不同侧弯类型和Cobb角的大小与肺功能受限无相关性。 -
关键词:
- 青少年特发性脊柱侧弯 /
- 肺功能 /
- 呼吸肌力 /
- Cobb角
Abstract:Objective To investigate the correlation between pulmonary function and respiratory muscle strength in adolescent idiopathic scoliosis （AIS） patients compared to healthy subjects of the same age, and to investigate the correlation between the size of the scoliosis angle and the type of scoliosis with pulmonary function and respiratory muscle strength in AIS patients. Methods We analyzed the lung function indicators of 50 patients with AIS （Cobb=29.720±11.875） and 50 healthy adolescents treated at the Department of Orthopedics, Second Affiliated Hospital of Kunming Medical University from June to December 2022. Pulmonary function indicators included forced vital capacity （FVC） as a percentage of predicted value （FVC pred%）, and forced expiratory volume in one second （FEV1）. （FEV1 pred%）, maximum expiratory flow volume （PEF pred%）, and the maximum expiratory rate in one second （FEV1/FVC）. Respiratory muscle function indicators included maximum expiratory pressure （MEP） and maximum inspiratory pressure （MIP）. Results There were no statistical differences in FEV1/FVC and PEF pred% between the AIS group and healthy controls, and FVC pred%, FEV1 pred% （P < 0.01）, inspiratory muscle strength, and expiratory muscle strength were worse in the AIS group than in the healthy group. There was no correlation between pulmonary function parameters, respiratory muscle strength, and Cobb’s angle, and no difference in pulmonary function and respiratory muscle strength between patients with different scoliosis types. Conclusions Patients with AIS have poorer FVC pred% and FEV1 pred%, and respiratory muscle strength than healthy subjects of the same age. Different types of lateral bending and the size of Cobb angle are not correlated with restricted lung function. -
表 1 2组一般资料比较（ $\bar x \pm s $）
Table 1. Comparison of two groups of general data （ $\bar x \pm s $）
组别 n 性别（n） 年龄
（岁）身高
（cm）体重
（kg）BMI（kg/m2） 男/女 侧弯组 50 5/45 14.920 ± 2.183 1.610 ± 0.075 47.536 ± 7.279 18.264 ± 2.009 健康组 50 6/44 14.240 ± 2.543 1.580 ± 0.099 46.930 ± 11.032 18.601 ± 3.186 χ2/t 0.090 1.696 1.694 0.324 −0.632 P 0.764 0.093 0.094 0.094 0.746 
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表 2 2组肺功能比较（ $\bar x \pm s $）
Table 2. Comparison of lung function between two groups （ $\bar x \pm s $）
组别 n FVC pred%（%） FEV1 pred%（%） FEV1 /FVC %pred（%） PEF pred%（%） 侧弯组 50 79.920 ± 9.733 80.740 ± 10.743 101.180 ± 8.270 78.440 ± 22.032 健康组 50 89.440 ± 15.602 88.980 ± 14.289 100.080 ± 9.341 86.140 ± 21.393 t −3.702 −3.274 0.638 −1.773 P < 0.001* 0.001* 0.525 0.079 *P < 0.05。
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表 3 2组呼吸肌力比较（ $\bar x \pm s $）
Table 3. Comparison of respiratory muscle strength between two groups （ $\bar x \pm s $）
组别 n MIP MEP 侧弯组 50 52.740 ± 17.073 64.940 ± 12.838 健康组 50 62.580 ± 16.970 74.120 ± 16.923 t −2.890 −3.056 P 0.005* 0.003* *P < 0.05。
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表 4 Cobb角与肺功能、呼吸肌力间的相关性
Table 4. Correlation of Cobb Angle with lung function and respiratory muscle strength
参数 Cobb角 r P FVC pred% −0.059 0.682 FEV1 pred% 0.029 0.844 FEV1 /FVC% pred 0.276 0.052 PEF pred% 0.077 0.594 MIP −0.079 0.587 MEP −0.096 0.507
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表 5 不同类型侧弯肺功能比较（ $\bar x \pm s $）
Table 5. Comparison of function of different types of lateral curved lung （ $\bar x \pm s $）
组别 n FVC pred%（%） FEV1 pred%
（%）FEV1 /FVC pred%（%） PEF pred%
（%）MIP MEP 胸弯型 6 77.330 ± 13.018 79.000 ± 13.416 102.000 ± 3.847 78.830 ± 23.676 44.500 ± 13.397 72.666 ± 11.775 腰弯型 11 79.360 ± 6.789 44.500 ± 13.397 104.730 ± 5.746 88.090 ± 23.696 53.545 ± 19.511 61.454 ± 10.957 以胸弯为主的双弯 13 79.080 ± 11.565 104.730 ± 5.746 101.070 ± .6.498 74.210 ± 20.599 52.428 ± 23.889 64.500 ± 18.529 以腰弯为主的双弯 14 78.830 ± 23.676 79.150 ± 9.512 100.690 ± 10.483 77.920 ± 22.232 54.538 ± 10.038 66.615 ± 7.794 胸腰弯型 6 81.000 ± 8.485 76.830 ± 12.952 95.170 ± 11.974 71.330 ± 21.621 56.333 ± 9.114 61.000 ± 8.555 F 0.328 1.077 1.365 0.802 0.438 0.942 P 0.858 0.379 0.261 0.531 0.780 0.448
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