Ultrasound And Electrophysiological Changes Of Paralyzed Diaphragm In Stroke Patients And Its Correlation With Serology

Objectives:To combine the effects of diaphragmatic ultrasound and neuroelectrophysiology on the evaluation of diaphragmatic function in patients with right hemiplegia after stroke,and to explore the correlation between serum creatinine/cystatin C,diaphragmatic thickness score,and inspiratory muscle strength in patients with right hemiplegia after strokeMethod:Thirty patients with right hemiplegia who met the inclusion and exclusion criteria were selected as the experimental group and 29 healthy persons as the control group:(1)Ultrasound was used to measure the thickness of the right diaphragm and calm end-expiratory muscles and take a deep breath.End-tidal thickness,calm breathing activity,Maximum deep breathing activity,and calculate the thickness score,thickness score=(deep inhalation thickness-calm end-tidal thickness)/calm end-tidal thickness.(2)Subjects underwent bilateral cervical phrenic nerve electrophysiological compound muscle action potential(CMAP)examination,and recorded bilateral phrenic nerve motor conduction latency and amplitude,respectively.(3)Collect the serum creatinine and cystatin C values of the subjects on the same day of the ultrasound examination,and collect the basic data of the subjects' gender,age,height and weight.The differences in diaphragm thickness,thickness score,diaphragm activity,and CMAP between the experimental group and the control group were analyzed,and the correlation between the serum creatinine/cystatin C and the score of diaphragm thickness and inspiratory muscle strength was analyzed.Results:1.Diaphragm ultrasound:Compared with the experimental group and the control group,the thickness of deep diaphragm muscles,diaphragm thickness score,calm breathing diaphragm muscle activity,and Maximum deep breathing diaphragm muscle activity were compared.The differences were statistically significant.(P<0.05).There was no statistically significant difference in the thickness of the diaphragm at the end of exhalation(P>0.05).2.Electrophysiology of bilateral phrenic nerves examination:latency period:The right side(affected side)of the experimental group is compared with the right side of the control group,the difference is statistically significant(P<0.01);the amplitude:the right side of the experimental group is compared with the left side,with a statistical difference Significance(P<0.05);the right side(affected side)of the experimental group was statistically significant compared with the right side of the control group(P<0.05).3.Correlation between serological indicators and diaphragm muscle ultrasound indicators:Pearson correlation analysis between serum creatinine/cystatin C ratio and diaphragm muscle thickness score in the experimental group,r=0.781,which has a strong correlation;Pearson correlation analysis between C ratio and diaphragm thickness score,r=0.769,with strong correlation.Conclusions:1.Ultrasound and phrenic motor conduction test can better reflect the function of diaphragmatic muscle in patients with stroke hemiplegia.The joint examination of the two can conduct multi-site integrity assessment of diaphragmatic dysfunction in patients with stroke hemiplegia 2.Serological indicators(blood creatinine/cystatin C)Has a medium-strength correlation with the strength of inspiratory muscles in assessing diaphragmatic mass in patients with right hemiplegia after stroke,so the former can reflect the strength of inspiratory muscles to a certain extent.3.Ultrasound and serum parameters(blood creatinine/cystatin C)have a strong correlation in assessing diaphragmatic muscle mass in patients with right hemiplegia due to stroke,Therefore,serological indicators(serum creatinine/cystatin C)can also reflect the functional status of the diaphragm to a certain extent...