Background

Interstitial lung diseases (ILDs) patients receiving steroid treatment tend to be immobilized by dyspnea and muscle weakness as the disease progresses. We therefore expected that steroid treatment for ILDs would have a greater effect on muscle function under severe dyspnea. To test this hypothesis, we evaluated whether the effect of corticosteroid treatment on peripheral muscle force and exercise capacity varied according to patients’ dyspnea severity.

Methods

In this retrospective cross-sectional study of 87 ILD patients enrolled between 2008 and 2017, quadriceps force (QF), handgrip force (HF), and 6-min walk distance (6 MWD) were compared between a low (grades 0–2) and a high (grades 3–4) modified-Medical Research Council (mMRC) dyspnea scale score group.

Results

In patients with lower levels of dyspnea, corticosteroid treatments were associated with lower QF and HF (20.0 vs. 30.0 kgf, p = 0.01; 22.5 vs. 28.4 kgf, p = 0.03, respectively) values; however, no significant differences were observed between the corticosteroid and control subgroups in the high mMRC group (QF: 18.5 vs. 17.3 kgf, p = 0.64; HF: 21.0 vs. 17.1 kgf, p = 0.24, respectively). Analysis of covariance indicated that both corticosteroid treatment and mMRC dyspnea scale interacted with QF, HF, and 6 MWD. The effects of the corticosteroid treatment varied according to the level of dyspnea (interaction β = 7.52, p = 0.034; interaction β = 8.78, p = 0.048; interaction β = 131.08, p < 0.001).

Conclusions

Muscle weakness and exercise capacity in ILD patients in the low mMRC group were associated with corticosteroid treatment.

中文翻译：

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糖皮质激素与间质性肺病轻度呼吸困难患者的骨骼肌功能降低有关

背景

随着疾病的进展，接受类固醇治疗的间质性肺病（ILD）患者往往会因呼吸困难和肌肉无力而被固定住。因此，我们预期类固醇激素治疗ILD会在严重呼吸困难下对肌肉功能产生更大的影响。为了验证这一假设，我们评估了皮质类固醇激素治疗对周围肌肉力量和运动能力的影响是否根据患者呼吸困难的严重程度而有所不同。

方法

在这项回顾性横断面研究中，对2008年至2017年期间入选的87名ILD患者进行了比较，比较低（0-2级）的四头肌力量（QF），握力（HF）和6分钟步行距离（6 MWD）。以及一个较高的（3-4年级）改良医学研究委员会（mMRC）呼吸困难量表评分组。

结果

在呼吸困难水平较低的患者中，皮质类固醇治疗的QF和HF值较低（分别为20.0 vs. 30.0 kgf，p = 0.01； 22.5 vs. 28.4 kgf，p = 0.03）。然而，在高mMRC组中，皮质类固醇与对照组之间没有显着差异（QF：18.5 vs. 17.3 kgf，p = 0.64； HF：21.0 vs. 17.1 kgf，p = 0.24 ）。协方差分析表明，皮质类固醇治疗和mMRC呼吸困难量表均与QF，HF和6 MWD相互作用。皮质类固醇激素治疗的效果随呼吸困难的程度而变化（相互作用β= 7.52，p = 0.034；相互作用β= 8.78，p = 0.048；相互作用β= 131.08，p <0.001）。

结论

低mMRC组的ILD患者的肌肉无力和运动能力与皮质类固醇激素治疗相关。