スモン患者の咳嗽力に関する検討

Peak Cough Flow in Patients with Subacute Myelo-optic Neuropathy

要旨：外来通院中のスモン患者7名（男性2名，女性5名，平均年齢81.6±7.2歳）を対象に咳嗽力の評価として，peak cough flow（以下PCF）を測定し，年齢，性別をマッチした対照群と比較した．歩行機能，Barthel Index，握力，発声持続時間も併せて測定し，PCFとの関連をスピアマンの順位相関係数およびピアソンの相関係数を用いて検討した．スモン患者群のPCFの平均値は218.6±66.2 L/min（110～300），対照群は267.1±76.3 L/min（170～360）であり，患者群で低い傾向を認めた．PCF低値の症例は，スモン患者7名中5名（71％）であった．110 L/minの症例は陳旧性肺結核の既往例であった．最長発声持続時間とPCFには強い相関を認めた．【結論】スモン患者の咳嗽力はやや低い傾向を認め，定期的な呼吸機能，咳嗽力の評価，および呼吸器合併症のリスクの軽減のための呼吸リハビリテーションの必要性が示唆された．

Abstract　Purpose : This study aims to measure the peak cough flow (PCF) in patients with subacute myelo-optic neuropathy (SMON) and study its relation with muscle strength, functional ability and vocal cord function. Methods : We performed a cross-sectional study in 7 patients with SMON (2 men and 5 women, mean age (SD) 81.6 (7.2) years) and in 7 age- and gender-matched patients with orthopedic problems as a control group. Their PCF, ability to walk, the Barthel Index, grip strength and maximum phonation time were assessed. Results : Mean PCF was 218.6±66.2 L/min (110-300) for the SMON group and 267.1±76.3 L/min (170-360) for the control group (ns). The PCF was correlated with the maximum phonation time (r＝0.91 ; p＜0.01), but not with grip strength, the Barthel Index or the ability to walk scale. Conclusion : The PCF in patients with SMON tended to be lower compared to the control group. Therefore, evaluating PCF is suggested to be necessary to assess the risk of pneumonia.