The Correlational Research Between Quadriceps Femoris Muscle Ultrasonic Indexes And Pulmonary Function Indexes In Patients With Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease(COPD)is the world’s third leading cause of death after ischemic heart disease and stroke.It is a progressive respiratory system disease caused by prolonged exposure to irritants that damage the lungs,such as smoking,air pollution,or chemical smoke,which can lead to difficulty breathing,slow development over time,and significantly affect a person’s quality of life.Unfortunately,COPD is still an incurable chronic disease,but it can be managed through appropriate treatments.This may include drug therapy(such as bronchodilators or corticosteroids),oxygen therapy,pulmonary rehabilitation,and lifestyle changes(such as quitting smoking or avoiding irritants).Severe cases may require surgery or lung transplantation.It is important to work with healthcare providers to develop personalized treatment plans for COPD.COPD is characterized by chronic airway inflammation and airflow limitation,which often leads to the destruction of lung tissue.COPD is often associated with muscle wasting,which is the cause of impaired functional capacity,reduced exercise tolerance,and increased mortality in COPD patients.Moreover,the skeletal muscle dysfunction in COPD is multifactorial,and its pathophysiological mechanisms are not fully understood.Furthermore,a large amount of clinical data indicates that it is the result of multiple factors,including systemic inflammation,oxidative stress,hypoxemia,lack of exercise,and malnutrition.Therefore,assessing the muscle mass and function of COPD patients is essential for the correct diagnosis,monitoring,and management of the disease.However,currently,the main assessment tool for the severity of COPD is pulmonary function tests,which are relatively limited and influenced by operators and patients.Some patients cannot tolerate the test due to severe breathing difficulties.Therefore,a new assessment tool for the severity of COPD is urgently needed.Ultrasound,as a non-invasive and economical imaging technique,has recently received considerable attention as a reliable tool for evaluating the muscle mass and function of COPD patients.Ultrasound can accurately measure muscle thickness,cross-sectional area,and structure,providing valuable information on muscle morphology,quality,and quantity.In recent years,extensive research has been conducted on using ultrasound to evaluate muscle mass and function in COPD patients,and the results show that ultrasound is a valuable tool for evaluating muscle mass in this population.The clinical application of ultrasound in muscle assessment for COPD patients has surpassed diagnosis and monitoring.Ultrasound can also be used to guide and monitor exercise interventions aimed at improving the muscle mass and function of COPD patients.For example,ultrasound can be used to measure changes in muscle thickness and cross-sectional area after exercise intervention.Additionally,ultrasound can be used to monitor changes in muscle activation and contraction speed,providing valuable feedback on the effectiveness of exercise programs.In conclusion,further exploration of the relationship between the ultrasonic indicators of skeletal muscle of COPD will improve our understanding of the pathophysiology of the disease and the development of more effective treatment strategies.Objective(s): This study aims to investigate the relationship between ultrasound indicators of the quadriceps femoris muscle and the severity of chronic obstructive pulmonary disease(COPD).We also aim to evaluate the clinical application of the quadriceps femoris muscle contraction index in COPD patients.Furthermore,we plan to compare the relationship between ultrasound indicators of the quadriceps femoris muscle and other severity-related indicators in COPD patients,such as pulmonary function and 6-minute walking distance.Methods: From 2020 to 2022,Stable COPD patients were recruited from the outpatient department of the Respiratory and Critical Care Medicine Department of a hospital.A total of 73 patients,including 60 males and 13 females,were enrolled based on inclusion and exclusion criteria.Demographic information,including gender,age,and body mass index(BMI),was recorded for all study subjects.Pulmonary function testing was performed using a spirometer,which measured forced expiratory volume in one second(FEV1),forced vital capacity(FVC),maximum voluntary ventilation(MVV),airway resistance(RAW),and lung capacity(VC).Ultrasound measurements of the quadriceps femoris muscle were taken,including quadriceps femoris muscle cross-sectional area(Qcsa),quadriceps femoris muscle thickness(Qthick),and quadriceps femoris muscle contraction index(Qci,defined as the ratio of quadriceps femoris muscle thickness to total anterior thigh thickness).Statistical analysis was conducted through spss 26.0 software.The measurement data were analyzed through independent sample t-test or Mann Whitney U-test.Spearman method was used to further verify the correlation between lung function indicators and muscle ultrasound results.Results:The results showed that:1.There was a significant difference(p<0.05)in the quadriceps muscle contraction index between male and female patients.2.In male COPD patients,there was a significant correlation(p<0.05)observed between the thickness of the right rectus femoris muscle,right vastus intermedius muscle,total thickness of the skin to the anterior edge of the femur on the right thigh,total thickness of the skin to the anterior edge of the femur on the left thigh,and the elasticity of the left rectus femoris muscle with the FEV1/FVC ratio.3.There was no correlation(p>0.05)between Qci and lung function indicators in male patients.4.In female COPD patients,only the elasticity of the right rectus femoris,thickness of the left rectus femoris,and total thickness of the left thigh skin to the anterior edge of the femur were significantly different(p<0.05)from lung function indicators.5.There was no correlation(p>0.05)between Qci and lung function indicators in female patients.6.6.There was a significant correlation between the thickness of the right rectus femoris muscle and FEV1 and Raw in male COPD patientsConclusion : The ultrasonic index of quadriceps femoris is significantly correlated with the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC),which is a common measure of lung function in COPD patients.This suggests that the ultrasonic index will serve as an objective indicator for the clinical diagnosis and evaluation of COPD patients.