肺功能及膈肌活动度与不同年龄慢性阻塞性肺疾病急性加重期患者发生高碳酸血症的相关性OA

Objective To investigate the associations of pulmonary function and diaphragmatic excursion with hy-percapnia in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 171 patients with severe or very severe AECOPD admitted to the Department of Respiratory and Critical Care Medicine,The First People's Hospital of Yulin,between January and October 2024 were enrolled.According to arterial partial pres-sure of carbon dioxide(PaCO2),patients were divided into a hypercapnia group(PaCO2 ≥50 mmHg)and a control group(PaCO2＜50 mmHg).Demographic characteristics,PaCO2,pulmonary function parameters,including the ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC),forced expiratory volume in the first second(FEV1),and FEV1 expressed as a percentage of the predicted value(FEV1％pred),as well as diaphragmatic excursion were collected.Differences in pulmonary function and diaphragmatic excursion between the two groups were analyzed,fol-lowed by age-stratified subgroup analyses(＜75 years and ≥ 75 years).Pearson correlation analysis and multivariable logistic regression analysis were performed to identify factors associated with hypercapnia.Results In the overall study population,FEV1％pred,FEV1,and FEV1/FVC were significantly lower in the hypercapnia group than in the control group(P＜0.05),whereas no significant difference in diaphragmatic excursion was observed between the two groups(P＞0.05).Subgroup analysis showed that diaphragmatic excursion was significantly lower in the hypercapnia group than in the control group only among patients aged＜75 years(P＜0.05).Correlation and multivariable regression analyses showed that FEV1％pred and diaphragmatic excursion were negatively correlated with PaCO2(P＜0.05)and were inde-pendently associated with a lower risk of hypercapnia,with odds ratios(ORs)of 0.862 and 0.934,respectively.Conclu-sion Hypercapnia in patients with AECOPD is associated with impaired pulmonary function.Higher FEV1％pred and greater diaphragmatic excursion are associated with a lower risk of hypercapnia and may serve as protective factors.Explor-atory subgroup analysis suggested a significant difference in diaphragmatic excursion between patients with and without hy-percapnia among those aged＜75 years;this finding requires further validation in prospective studies.