The utility of the diaphragm ultrasound in patients with COPD

2021 Fiscal Year Final Research Report

• Project/Area Number: 17K18089
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: General internal medicine(including psychosomatic medicine); Respiratory organ internal medicine
• Research Institution: Kyorin University
• Principal Investigator: Mikura Sunao 杏林大学, 医学部, 助教 (90791723)
• Project Period (FY): 2017-04-01 – 2022-03-31
• Keywords: COPD / 横隔膜超音波 / 身体所見 / 診断研究 / 閉塞性換気障害 / 重症度 / 横断研究

Outline of Final Research Achievements

A total of 25 patients were assessed (median age, 75 (interquartile range (IQR)) 74-77) years; FEV1 44.6 (IQR 35-56.3) % predicted). The reference standard was GOLD COPD stages and %FEV1, and index tests were total abnormal physical signs (TAPS) or the parameters of diaphragm ultrasound, thickness at tidal inspiration (Tdi-inspiration), thickness at tidal expiration (Tdi-expiration), and the fraction of these (Δtdi%). The AUCs for the three diaphragm parameters were Tdi at quiet inspiration, 0.63 (95% CI, 0.43-0.82); Tdi at quiet expiration, 0.61 (95% CI, 0.39-0.79); Tdi%, 0.49 (95% CI, 0.28-0.69). The AUC for the TAPS was 0.930 (95% C.I. 0.74-0.99). TAPS correlated with %FEV1 (r = -0.81; p < 0.05) significantly, while the parameters of diaphragm ultrasound were not.

Free Research Field

慢性閉塞性肺疾患

Academic Significance and Societal Importance of the Research Achievements

健常者とCOPD罹患者の鑑別を目的とした研究では, 横隔膜超音波の有用性が他の探索的研究で示されている. また, COPD内での評価も他国で行った論文も出版され, 本研究と結果は類似していた. 身体所見については, 今まで総得点の診断性能を感度特異度という形で報告したものはなかったため, 今後のより妥当性の高い研究へとつながる可能性がある.