Correlation analysis of transthoracic ultrasound elastic imaging characteristics and disease conditions in patients with chronic obstructive pulmonary disease

doi:10.3877/cma.j.issn.1674-6902.2025.02.010

Abstract

Abstract:

Objective

To investigate the relationship between the characteristics of chronic obstructive pulmonary disease （COPD） and the obstructive pulmonary disease with transthoracic ultrasonography.

Methods

All fo 57 patients with stable COPD who were admitted to our hospital from June 2021 to June 2023 were selected to examine lung function by ultrasound elastography. According to the disease condition，21 cases of severe patients were divided into observation group and 36 cases of mild and moderate patients were divided into control group. The clinical data，lung function and transthoracic ultrasound elastography were compared between the two groups. Multivariate Logistic regression was used to analyze the correlation between the characteristics of transthoracic elastography and the severity of COPD.

Results：

There was no significant difference in age，blood sugar and other clinical data between the two groups （P＞0.05）. Intercostal muscle thickness index（ICMTei）（0.33±0.07） cm and intercostal muscle shear wave elastography（ICMswe）（0.35±0.08） cm in the observation group were lower than those in the control group ICMTei （0.42±0.10） cm （t=2.262，P=0.028），ICMswe（0.46±0.11） cm （t=2.649，P=0.011），diaphragmatic thickness at the end of inspiration（DTei）（27.71±4.13） kPa and diaphragmshear wave elastography（ Dswe）（24.78±3.61） kPa in observation group were higher than DTei （22.19±3.58） kPa （t=3.553，P=0.001），Dswe （17.42±2.83）kPa （t=4.738，P=0.000）in control group. FEV₁（1.13±0.12） L，FVC （1.65±0.26） L，FEV₁/FVC （48.26±2.81）% in the observation group were lower than those in the control group FEV₁（1.42±0.15）L （t=7.340，P=0.000），FVC（1.85±0.31）L （t=4.689，P=0.000），FEV₁/FVC （（58.35±3.23）% （t=11.916，P=0.000）. Multivariate Logistic regression analysis showed that ICMTei （OR=4.63×10^-8） and ICMswe （OR=2.03×10^-4） were protective factors for the severity of COPD. DTei （OR=1.437） and Dswe （OR=1.448） were risk factors for COPD severity. FEV₁，FVC and FEV₁/FVC were positively correlated with IICMTei and ICMswe （P＜0.05），and negatively correlated with DTei and Dswe （P ＜0.05）.

Conclusion

The characteristics of transthoracic elastography are correlated with the severity of COPD. DTei and Dswe are risk factors，ICMTei and ICMswe are protective factors.

Key words: Chronic obstructive pulmonary disease, Transthoracic ultrasound elastography, State of the disease, Multivariate Logistic regression analysis

Fengmei Fu, Fengkai Fang, Meichui Fu, Wuju Xie, Zhenliang Xu, Yanshen Hu. Correlation analysis of transthoracic ultrasound elastic imaging characteristics and disease conditions in patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(02): 256-260.

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URL: https://zhfbjbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6902.2025.02.010

https://zhfbjbzz.cma-cmc.com.cn/EN/Y2025/V18/I02/256

Figures/Tables 3

临床资料	观察组（n=21）	对照组（n=36）	t /χ ²	P值
病程［年，（ $\overset{ˉ}{x}$ ± s ）］	5.03±0.47	4.86±0.45	1.660	0.103
心率［次/ min，（ $\overset{ˉ}{x}$ ± s ）］	73.28±10.05	72.75±9.87	0.235	0.815
呼吸［次/ min，（ $\overset{ˉ}{x}$ ± s ）］	18.14±2.01	17.83±1.82	0.819	0.416
SpO₂［％，（ $\overset{ˉ}{x}$ ± s ）］	91.37±17.28	92.10±16.65	0.418	0.677
血糖［mmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	5.13±0.94	5.20±0.82	0.462	0.646
甘油三酯［mmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	1.53±0.37	1.61±0.40	0.295	0.769
胆固醇［mmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	5.78±1.23	5.82±1.21	0.423	0.674
ALT［U/ L，（ $\overset{ˉ}{x}$ ± s ）］	8.37±2.04	7.95±1.98	0.637	0.527
AST［U/ L，（ $\overset{ˉ}{x}$ ± s ）］	10.68±2.32	11.07±2.18	0.545	0.588
白细胞［10⁹ / L，（ $\overset{ˉ}{x}$ ± s ）］	6.11±1.68	5.86±2.00	0.789	0.434
血小板计数［10⁹ / L，（ $\overset{ˉ}{x}$ ± s ）］	182.37±41.71	181.65±40.74	0.221	0.826
肌酐［μmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	62.36±8.75	61.74±9.03	0.228	0.821
尿素氮［mmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	5.82±1.38	5.79±1.29	0.106	0.916
凝血酶原时间［s，（ $\overset{ˉ}{x}$ ± s ）］	12.51±2.65	13.02±2.81	0.834	0.408
血红蛋白［g/ L，（ $\overset{ˉ}{x}$ ± s ）］	130.21±10.03	129.88±9.78	0.345	0.732
白蛋白［g/ L，（ $\overset{ˉ}{x}$ ± s ）］	40.82±4.36	39.97±4.21	0.627	0.533
C 反应蛋白［mg/ L，（ $\overset{ˉ}{x}$ ± s ）］	5.07±0.62	4.85±0.70	1.213	0.230
白介素-6［pg/ ml，（ $\overset{ˉ}{x}$ ± s ）］	35.36±5.72	34.58±4.94	0.508	0.614

临床资料	观察组（n=21）	对照组（n=36）	t /χ ²	P值
病程［年，（ $\overset{ˉ}{x}$ ± s ）］	5.03±0.47	4.86±0.45	1.660	0.103
心率［次/ min，（ $\overset{ˉ}{x}$ ± s ）］	73.28±10.05	72.75±9.87	0.235	0.815
呼吸［次/ min，（ $\overset{ˉ}{x}$ ± s ）］	18.14±2.01	17.83±1.82	0.819	0.416
SpO₂［％，（ $\overset{ˉ}{x}$ ± s ）］	91.37±17.28	92.10±16.65	0.418	0.677
血糖［mmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	5.13±0.94	5.20±0.82	0.462	0.646
甘油三酯［mmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	1.53±0.37	1.61±0.40	0.295	0.769
胆固醇［mmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	5.78±1.23	5.82±1.21	0.423	0.674
ALT［U/ L，（ $\overset{ˉ}{x}$ ± s ）］	8.37±2.04	7.95±1.98	0.637	0.527
AST［U/ L，（ $\overset{ˉ}{x}$ ± s ）］	10.68±2.32	11.07±2.18	0.545	0.588
白细胞［10⁹ / L，（ $\overset{ˉ}{x}$ ± s ）］	6.11±1.68	5.86±2.00	0.789	0.434
血小板计数［10⁹ / L，（ $\overset{ˉ}{x}$ ± s ）］	182.37±41.71	181.65±40.74	0.221	0.826
肌酐［μmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	62.36±8.75	61.74±9.03	0.228	0.821
尿素氮［mmol/ L，（ $\overset{ˉ}{x}$ ± s ）］	5.82±1.38	5.79±1.29	0.106	0.916
凝血酶原时间［s，（ $\overset{ˉ}{x}$ ± s ）］	12.51±2.65	13.02±2.81	0.834	0.408
血红蛋白［g/ L，（ $\overset{ˉ}{x}$ ± s ）］	130.21±10.03	129.88±9.78	0.345	0.732
白蛋白［g/ L，（ $\overset{ˉ}{x}$ ± s ）］	40.82±4.36	39.97±4.21	0.627	0.533
C 反应蛋白［mg/ L，（ $\overset{ˉ}{x}$ ± s ）］	5.07±0.62	4.85±0.70	1.213	0.230
白介素-6［pg/ ml，（ $\overset{ˉ}{x}$ ± s ）］	35.36±5.72	34.58±4.94	0.508	0.614

影响因素	B	标准误	瓦尔德	P值	OR	95％置信区间
影响因素	B	标准误	瓦尔德	P值	OR	下限	上限
ICMTei	-16.887	6.847	6.084	0.014	4.63×10^-8	0.000	0.031
ICMswe	-8.501	4.304	3.901	0.048	2.03×10^-4	0.000	0.937
DTei	0.363	0.151	5.758	0.016	1.437	1.069	1.933
Dswe	0.370	0.142	6.782	0.009	1.448	1.096	1.913

项　目	统计值	FEV₁	FVC	FEV₁ / FVC
ICMTei	r值	0.528	0.437	0.614
	P值	0.000	0.000	0.000
ICMswe	r值	0.493	0.526	0.652
	P值	0.000	0.000	0.000
DTei	r值	-0.530	-0.494	-0.541
	P值	0.000	0.000	0.000
Dswe	r值	-0.487	-0.579	-0.634
	P值	0.000	0.000	0.000

References 28

1	Li Z，Zhang Y，Wang J，et al. Difference of body surface temperature in stable chronic obstructive pulmonary disease patients with different degree of airflow limitation［J］. Heart Lung，2022，52（1）： 130-135.
2	Yang M，Xu Y，Chen H，et al. Benefits and risks of low molecular weight heparin in patients with acute exacerbation of chronic obstructive pulmonary disease： a meta-analysis of randomized controlled trials［J］. Inflammopharmacology，2020，28（2）： 451-462.
3	Shu H，Peng Y，Hang W，et al. The role of CD36 in cardiovascular disease［J］. Cardiovasc Res，2022，118（1）： 115-129.
4	陈荣昌，梁振宇，王凤燕. 我国慢性阻塞性肺疾病早期防控的现状、挑战与思考［J］. 中华健康管理学杂志，2022，16（2）：73-76.
5	张诚实，程炜炜，崔栋慧，等. MPV/PLT 比值对老年慢性阻塞性肺疾病合并呼吸衰竭患者严重程度及预后的评估价值［J］.老年医学与保健，2023，29（4）： 765-769.
6	Jacobsen PA，van't Hul AJ，Djamin RS，et al.Characteristics and treatable traits of patients with chronic obstructive pulmonary disease（COPD） with and without paid employment［J］. Respir Res，2021，22 （1）： 147.
7	Labaki WW，Rosenberg SR. Chronic obstructive pulmonary disease［J］. Ann Intern Med，2020，173（3）： ITC17-ITC32.
8	陈梦，王白冰，王丹丹，等. 超声评估膈肌功能的应用进展［J］. 临床超声医学杂志，2022，24（5）： 378-381.
9	石豆子，刘蓉，陈悦，等. 实时剪切波弹性成像技术评估正常人膈肌功能的初步研究［J］. 中国临床医学影像杂志，2023，34（1）： 33-36.
10	王舰尧，高占成，王雪，等. 超声评估慢性阻塞性肺疾病患者膈肌功能与肺功能关联性研究［J］. 中国超声医学杂志，2020，36（12）： 1078-1080.
11	中华医学会呼吸病学分会慢性阻塞性肺疾病学组，中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南（2021 年修订版）［J］. 中华结核和呼吸杂志，2021，44（3）： 170-205.
12	Riley CM，Sciurba FC. Diagnosis and outpatient management of chronic obstructive pulmonary disease：a review［J］. JAMA，2019，321（8）： 786-797.
13	王妍，闫巍，柯楠. 慢性阻塞性肺疾病前期特征、潜在诊断方法及干预策略［J］. 实用心脑肺血管病杂志，2023，31（10）： 1-5.
14	Ritchie AI，Wedzicha JA. Definition，causes，pathogenesis，and consequences of chronic obstructive pulmonary disease exacerbations［J］. Clin Chest Med，2020，41（3）： 421-438.
15	Machado FVC，Spruit MA，Groenen MTJ，et al. Frequency and functional translation of low muscle mass in overweight and obese patients with COPD［J］. Respir Res，2021，22（1）： 93.
16	任成山，王关嵩，钱桂生. 慢性阻塞性肺疾病的成因及其治疗的困惑与希望［J/CD］. 中华肺部疾病杂志（电子版），2019，12（2）： 127-141.
17	Kim T，Huh S，Chung JH，et al. Clinical values of diaphragmatic movement in patients with chronic obstructive pulmonary disease［J］. BMC Pulm Med，2023，23（1）： 33.
18	朱家安. 弹性成像在肌骨超声中的应用［J］. 临床超声医学杂志，2020，23（7）： 481-482.
19	曹军英，金壮. 肌骨超声在临床诊断中的应用进展［J］. 中国现代医学杂志，2022，32（22）： 1-5.
20	Schulz A，Erbuth A，Boyko M，et al. Comparison of ultrasound measurements for diaphragmatic mobility，diaphragmatic thickness，and diaphragm thickening fraction with each other and with lung function in patients with chronic obstructive pulmonary disease［J］.Int J Chron Obstruct Pulmon Dis，2022，17： 2217-2227.
21	Baqdunes MW，Leap J，Young M，et al. Acute exacerbation of chronic obstructive pulmonary disease［J］. Crit Care Nurs Q，2021，44（1）：74-90.
22	Mathioudakis AG，Janssens W，Sivapalan P，et al. Acute exacerbations of chronic obstructive pulmonary disease：in search of diagnostic biomarkers and treatable traits［J］. Thorax，2020，75（6）： 520-527.
23	D′Andrea A，Banfi C，Bendjelid K，et al.The use of extracorporeal carbon dioxide removal in acute chronic obstructive pulmonary disease exacerbation：a narrative review［J］. Can J Anaesth，2020，67（4）： 462-474.
24	於建平，李国平，陈凯，等. 慢性阻塞性肺疾病患者外周血单个核细胞CD36 mRNA、血清ApoE 水平对急性加重期发生的预测价值［J］. 浙江中西医结合杂志，2023，33（9）： 816-819+824.
25	Ji M，Ikegami T，Debru E，et al. Parasternal intercostal function during sustained hypoxia［J］. J Appl Physiol（1985），2022，132（3）： 622-631.
26	Xu JH，Wu ZZ，Tao FY，et al. Ultrasound shear wave elastography for evaluation of diaphragm stiffness in patients with stable COPD：A pilot trial［J］. J Ultrasound Med，2021，40（12）： 2655-2663.
27	王丽芸，邱逦. 超声弹性成像在肌肉硬度评估中的应用进展［J］. 国际医学放射学杂志，2019，42（1）： 90-93.
28	Dalle S，Koppo K. Is inflammatory signaling involved in diseaserelated musclewasting？Evidencefromosteoarthritis，chronicobstructivepulmonarydiseaseandtype Ⅱdiabetes ［ J］. Exp Gerontol，2020，137： 110964.

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