Ultrazvučna procjena pokretljivosti dijafragme u bolesnika sa sistemskom sklerozom s intersticijskom bolesti pluća i bez nje

doctoral thesis

• Title (english): Ultrasound assessment of diaphragm mobility in patients with systemic sclerosis with and without interstitial lung disease
• Author: Anja Ljilja Posavec
• Mentor: Joško Mitrović (mentor)
• Mentor: Nevenka Piskač Živković (komentor)
• Committee member: Marko Jakopović (predsjednik povjerenstva)
• Committee member: Miroslav Mayer (član povjerenstva)
• Committee member: Marija Gomerčić Palčić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2024-11-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Clinical Immunology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Sistemska skleroza (SSc) kronična je multisistemska autoimuna bolest nepoznate etiologije. Bolest često zahvaća pluća (SSc-ILD) i gastrointestinalni sustav. Dijafragma je glavni mišić u fiziologiji disanja te sudjeluje u više od 70 % minutne ventilacije.
Cilj ove disertacije bio je procijeniti je li dijafragmalna pokretljivost, debljina i frakcija zadebljanja (DTF) reducirana u bolesnika koji boluju od SSc-ILD-a u odnosu na pacijente bez ILD-a.
U ovome presječnom istraživanju istražena je povezanost ultrazvukom mjerene pokretljivosti, debljine dijafragme i DTF pacijenata sa SSc-ILD-om i bez ILD-a s kliničkim parametrima poput plućne funkcije, Warrickovim skorom, gastroezofagealnim simptomima, promjerima jednjaka, modificiranim Rodnanovim kožnim testom (mRSS) i modificiranom skalom dispneje britanskog Medicinskog istraživačkog vijeća (mMRC).
Rezultati istraživanja pokazali su da bolesnici sa SSc-ILD-om imaju manju pokretljivost dijafragme pri dubokom disanju odnosu na bolesnike bez ILD-a. Bolesnici koji imaju smanjenu pokretljivost dijafragme imaju više vrijednosti mMRC skale dispneje, viši mRSS, niže vrijednosti plućne funkcije, viši Warrickov skor te šire promjere jednjaka. Nije utvrđena značajna razlika u debljini dijafragme i DTF. Tri pacijenta (6 %) sa SSc su imali smanjenu debljinu dijafragme. Medijan vrijednosti DTF bio je 48 %. UZV dijafragme je korisna, neinvazivna metoda za procjenu funkcije dijafragme u bolesnika sa SSc.

Abstract (english)

Systemic sclerosis (SSc) is a chronic multisystem autoimmune disease of unknown etiology. The disease often affects lungs (SSc-ILD) and the gastrointestinal system. The diaphragm is the main muscle in the physiology of respiration and is responsible for more than 70 % of minute ventilation.
The aim of this dissertation was to evaluate whether diaphragmatic mobility, thickness and thickening fraction (DTF) is reduced in patients suffering from SSc-ILD compared to patients without ILD.
In this cross-sectional study, the association of ultrasound-measured mobility, diaphragm thickness, and DTF of patients with SSc-ILD and without ILD with clinical parameters such as lung function, Warrick score, gastroesophageal symptoms, esophageal diameters, modified Rodnan skin score (mRSS) and modified British Medical Research Council (mMRC) dyspnea scale was investigated.
The research results demonstrated that patients with SSc-ILD have lower mobility of the diaphragm during deep breathing compared to patients without ILD. Patients who have reduced diaphragm mobility have higher mMRC dyspnea scale results, higher mRSS, lower pulmonary function results, higher Warrick score and wider esophageal diameters. No significant difference was found in diaphragm thickness and DTF. Three patients (6 %) with SSc had reduced diaphragm thickness. The median DTF value was 48 %. Ultrasound of the diaphragm is a useful, non-invasive method for evaluating diaphragm function in patients with SSc.

• Keywords: sistemska skleroza; intersticijske bolesti pluća; ultrazvuk; dijafragma; testovi plućne funkcije; kompjuterizirana tomografija
• Keywords (english): systemic sclerosis; interstitial lung disease; ultrasound; diaphragm; lung function tests; computed tomography
• Language: croatian
• URN:NBN: urn:nbn:hr:105:810876
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 82 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-11-28 10:48:58