Canan CİMŞİT, Melahat BEKİR, SAİT KARAKURT, Emel ERYÜKSEL

Ultrasound assessment of diaphragm thickness in COPD

Amaç: Kronik obstrüktif akciğer hastalığı (KOAH) olan hastaların, diyafram kalınlıklarının ultrasonografi ile ölçülerek solunum fonksiyon testleri ve semptom skorları ile ilişkisinin araştırılmasıdır. Hastalar ve Yöntem: KOAH nedeniyle takip edilmekte olan, son iki aydır klinik olarak stabil seyirli 53 hasta çalışmamıza dahil edildi. Bronkodilatör sonrası 1 saniyedeki zorlu ekspiryum volum (%FEV1) değerlerinde %12 artış, çalışmada uygulanan testlerden herhangi birine uyumsuzluk, oksijen bağımlılığı, abdominal ya da torasik cerrahi geçirme hikayeleri çalışmadan dışlanma kriterleri olarak belirlendi. KOAH düzeyi spirometri ölçümlerine ve kronik obstüriktif akciğer hastalığına karşı global işbirliği (GOLD)kriterlerine göre sınıflandırıldı.Hayat kalitesi değerlendirmesi için mMrC ve CAT semptom skorları testleri ile kompozit KOAH skor ölçümü hesaplanması için alevlenme sayıları sorularak kaydedildi.Bulgular: KOAH düzeyi hafif olan hastalarda FEV1 % ile diyafram kalınlığı arasında anlamlı ilişki bulundu (r=0,62, p=0,017

KOAH'ta diyafragm kalınlığının ultrasonografi ile değerlendirilmesi

Objective: Thickness of the diaphragm was evaluated by B-mode ultrasonography (US) in chronic obstructive pulmonary disease (COPD) to determine the relationship between diaphragm thickness measurement, pulmonary function tests, and symptom scores. Patients and Methods: Fifty-three clinically stable patients with COPD were enrolled in this study for diaphragmatic thickness evaluation with B- mode US. The severity of COPD was determined by spirometric measurements in terms of forced expiratory volume in one second (FEV1%). Patients were also analyzed according to the global initiative for chronic obstructive lung disease (GOLD) criteria. Correlation between diaphragm thickness and symptom scores like modified Medical research Council (mMrC), COPD Assessment Test (CAT), composite scores and body mass index (BMI) were sought. Results: There was a moderate correlation between diaphragmatic muscle thickness and FEV1% in mild COPD patients (r=0.62, p=0.017<0.05). No significant difference in diaphragmatic thicknesses of GOLD subgroups was found. There were no correlations between diaphragmatic muscle thickness, symptom scores, BMI age, and gender.Conclusion: No correlation was found between diaphragmatic thickness in COPD patients and pulmonary function tests except for FEV1% in mild COPD patients. There were no correlations between diaphragmatic muscle thickness and symptom scores. Further US studies should take place for functional evaluation of the diaphragm in COPD subgroups.

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