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Physiology of respiratory disturbances in muscular dystrophies

机译:肌肉营养不良的呼吸障碍生理学

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摘要

Muscular dystrophy is a group of inherited myopathies characterised by progressive skeletal muscle wasting, including of the respiratory muscles. Respiratory failure, i.e. when the respiratory system fails in its gas exchange functions, is a common feature in muscular dystrophy, being the main cause of death, and it is a consequence of lung failure, pump failure or a combination of the two. The former is due to recurrent aspiration, the latter to progressive weakness of respiratory muscles and an increase in the load against which they must contract. In fact, both the resistive and elastic components of the work of breathing increase due to airway obstruction and chest wall and lung stiffening, respectively.The respiratory disturbances in muscular dystrophy are restrictive pulmonary function, hypoventilation, altered thoracoabdominal pattern, hypercapnia, dyspnoea, impaired regulation of breathing, inefficient cough and sleep disordered breathing. They can be present at different rates according to the type of muscular dystrophy and its progression, leading to different onset of each symptom, prognosis and degree of respiratory involvement.Key points class="unordered" style="list-style-type:disc">A common feature of muscular dystrophy is respiratory failure, i.e. the inability of the respiratory system to provide proper oxygenation and carbon dioxide elimination.In the lung, respiratory failure is caused by recurrent aspiration, and leads to hypoxaemia and hypercarbia.Ventilatory failure in muscular dystrophy is caused by increased respiratory load and respiratory muscles weakness.Respiratory load increases in muscular dystrophy because scoliosis makes chest wall compliance decrease, atelectasis and fibrosis make lung compliance decrease, and airway obstruction makes airway resistance increase.The consequences of respiratory pump failure are restrictive pulmonary function, hypoventilation, altered thoracoabdominal pattern, hypercapnia, dyspnoea, impaired regulation of breathing, inefficient cough and sleep disordered breathing.Educational aims class="unordered" style="list-style-type:disc">To understand the mechanisms leading to respiratory disturbances in patients with muscular dystrophy.To understand the impact of respiratory disturbances in patients with muscular dystrophy.To provide a brief description of the main forms of muscular dystrophy with their respiratory implications. class="head no_bottom_margin" id="idm140446879162448title">Short abstract>Respiratory failure is a common feature of and the main cause of death in muscular dystrophy
机译:肌营养不良症是一组遗传性肌病,其特征是进行性骨骼肌消瘦,包括呼吸肌消瘦。呼吸衰竭,即当呼吸系统的气体交换功能失效时,是肌营养不良症的常见特征,是死亡的主要原因,并且是肺衰竭,泵衰竭或两者结合的结果。前者归因于反复抽吸,后者归因于呼吸肌进行性无力和必须收缩的负荷增加。实际上,呼吸作用的阻力和弹性成分都分别由于气道阻塞,胸壁和肺部僵硬而增加。肌肉营养不良的呼吸系统疾病包括限制性肺功能,通气不足,胸腹模式改变,高碳酸血症,呼吸困难,受损呼吸调节,低效咳嗽和睡眠呼吸障碍。根据肌营养不良的类型及其进展,它们的出现率可能不同,从而导致每种症状的发作,预后和呼吸系统受累程度的不同。要点 class =“ unordered” style =“ list-style-type :disc“> <!-list-behavior =无序前缀词= mark-type = disc max-label-size = 0-> 肌肉营养不良的一个共同特征是呼吸衰竭,即无法呼吸系统可提供适当的氧合和二氧化碳消除。 在肺中,呼吸衰竭是由反复抽吸引起的,并导致低氧血症和高碳血症。 肌肉营养不良的通气衰竭是 肌营养不良症的呼吸负荷增加,因为脊柱侧弯使胸壁顺应性降低,肺不张和纤维化使肺顺应性降低,气道阻塞使气道阻力增加。 > 后果呼吸泵衰竭的原因包括限制性肺功能,通气不足,胸腹模式改变,高碳酸血症,呼吸困难,呼吸调节受损,咳嗽效率低下和睡眠呼吸障碍。 教育目标 class =“ unordered” style = “ list-style-type:disc”> <!-list-behavior = unordered prefix-word = mark-type = disc max-label-size = 0-> 了解导致呼吸系统疾病的机制肌营养不良患者。 了解呼吸障碍对肌营养不良患者的影响。 简要介绍肌营养不良的主要形式及其呼吸意义。< / li> class =“ head no_bottom_margin” id =“ idm140446879162448title”>简短摘要 >呼吸衰竭是肌肉营养不良的常见特征,也是主要的死亡原因

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