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探讨慢性阻塞性肺疾病 (COPD)患者呼吸肌体表肌电监测的临床意义及其与血气分析的相关性。方法 :选择 3 2名COPD患者作为实验组 ,观察治疗前后膈肌、肋间肌肌电振幅、中位频率及血气分析的动态变化。另选择 6名健康志愿者作为正常对照组。结果 :实验组膈肌和肋间肌振幅分别高于对照组的膈肌振幅(P <0 .0 5)和肋间肌振幅 (P <0 .0 0 1) ,服用具有兴奋呼吸中枢、扩张支气管作用的药物Pimexone 2h后 ,所有受试者的肌电振幅及COPD组的中位频率均较前下降 ,同时实验组PaO2 较服药前增加 (P <0 .0 1)。实验组服药前肋间肌振幅与PaO2 呈负相关 ,r=-0 .4 863 (P <0 .0 1) ,与PaCO2 呈正相关 ,r =0 .53 0 5(P <0 .0 1) ;服药后肋间肌中位频率与PaCO2 呈负相关 ,r =-0 .4 92 4 (P <0 .0 1)。结论 :体表动态监测COPD患者肌电变化 ,能反映其呼吸肌功能状态 ;肋间肌肌电振幅及中位频率与血气分析具有较好的相关性。
To investigate the clinical significance of respiratory muscle surface EMG monitoring in patients with chronic obstructive pulmonary disease (COPD) and its correlation with blood gas analysis. Methods: Thirty two COPD patients were selected as experimental group. The changes of EMG amplitude, median frequency and blood gas analysis before and after treatment were observed. Another six healthy volunteers as normal control group. Results: The amplitude of diaphragmatic muscle and intercostal muscle in the experimental group were significantly higher than those in the control group (P <0.05) and intercostal muscle amplitude (P <0.01) (P <0.01), the amplitude of EMG and the median frequency of COPD in all subjects decreased compared with that of the control group (P <0.01). The amplitude of intercostal muscle in experimental group was negatively correlated with PaO2, r = -0.48663 (P <0.01), and was positively correlated with PaCO2 (r = 0.0553, P <0.01) Median intercostal muscle frequency was negatively correlated with PaCO2, r = -0.492 4 (P <0.01). Conclusion: EMG changes of body surface can be dynamically monitored to reflect the functional status of respiratory muscles. EMG amplitude and median frequency of intercostal muscles have good correlation with blood gas analysis.