脉冲振荡法与舒张试验结合对支气管哮喘与慢性阻塞性肺疾病鉴别诊断的意义  

The value of combining impulse oscillometry with bronchodialtion test for differential diagnosis between asthma and COPD

作　　者：刘领[1] 赵淑敏[1] 卢青[1] 杨霁[1] 李秀业[1] 吴文杰[1] 

机构地区：[1]北京市垂杨柳医院,北京100022

出　　处：《国外医学（内科学分册）》2006年第8期366-368,F0003,共4页Foreign Medical Sciences(Section of Internal Medicine)

摘　　要：目的探讨脉冲振荡法(IOS)与舒张试验结合对支气管哮喘与慢性阻塞性肺疾病(COPD)鉴别诊断的意义。方法随机对60例急性期哮喘及78例COPD患者在喷药前后分别进行包括IOS、常规肺通气在内的肺功能检测,比较两组喷药前后IOS测得值及其变化程度的差异。结果喷药前支气管哮喘与COPD组IOS值差异无显著性(P＞0．05),但喷药后支气管哮喘组包括Fres、R5-R20、R5．X5在内的IOS值变化幅度均明显大于COPD组(P均＜0．05)。支气管哮喘组与FEV_(?)增加相关性密切的IOS指标依次为Fres＞R5- R20＞R5＞X5。结论支气管哮喘与COPD患者脉冲振荡结果均显示气道阻力增加与肺顺应性降低,但IOS与舒张试验结合有助于两者鉴别诊断。Objective To explore the value of combining impulse oscillometry （IOS） with bronchodialtion test for differentiation diagnosis between asthma and chronic obstructive pulmonary disease. Methods Sixty patients with acute asthma and 78 patients with chronic obstructive pulmonary disese （COPD） were randomly picked up for impulse oscillometry and conventional pulmonary function before and after inhaling Salbutamol. The IOS indices and the change degree were compared between two groups before and after bronchodiahion test. Results There was no significant difference for IOS indices between two group before inhaling Salbutamol（ P 〉 0 05 ）, but the chang degree of IOS indics including Fres ,RS-R20 ,RS, X5 were significantly greater in asthma group than that in COPD group （ P 〈0. 05 ）. In asthma group, the correlation between IOS indics and FEV1 improvement was Fres ,RS-R20 ,R5 and X5 in turn. Conclusions Increased respiratory impedance and decreased reactance are shown in asthma as well as COPD patients, but combining impulse oscillometry （IOS） with bronchodiahion test is helpful for differential diagnosis between asthma and COPD.

关 键 词：脉冲振荡法 舒张试验 支气管哮喘 慢性阻塞性肺疾病 

分 类 号：R562.2[医药卫生—呼吸系统]