呼气负压技术在检测慢性阻塞性肺疾病中的应用  

A new method to detect expiratory flow limitation in chronic obstructive pulmonary disease patients

作　　者：陈瑞[1] 陈荣昌 陈炼[3] 陈爱欢[2] 

机构地区：[1]中山大学附属二院呼吸内科,广州510120 [2]广州医学院第一附属医院 [3]广东省人民医院门诊部

出　　处：《中华医学杂志》2007年第7期448-450,共3页National Medical Journal of China

基　　金：广东省科学技术厅资助项目(C31106);广东省卫生厅资助项目(A2000267)

摘　　要：目的探讨应用呼气负压(NEP)技术检测慢性阻塞性肺疾病(COPD)患者呼气流速受限(EFL)的临床价值。方法采用 NEP 技术检测54例 COPD 患者和8例不能完成常规肺功能检查的 COPD 患者 EFL。结果 54例 COPD 患者中有41例检测到 EFL,5分法 EFL 评分2分组(55.71%±11.77%)、3分组(41.21%±13.69%)、4分组(29.84%±11.65%)1秒钟用力呼气量占预计值百分比(FEV_1%)低于0分组(83.76%±16.44%)。多元逐步回归分析表明,5分法 EFL 评分是最先进入因素,并与呼吸困难相关性最好。8例 COPD 患者均能耐受 NEP 测试。结论与 FEV_1%相比,5分法EFL 评分是评价 COPD 患者呼吸困难更可靠的指标;NEP 技术操作简单、不需患者主动配合,可在不能完成常规肺功能检查的患者中应用。Objective To explore the significance of negative expiratory pressure （NEP）technique in detecting expiratory flow hmitation（EFL） in the chronic obstructive pulmonary disease （COPD） patients. Methods NEP technique was performed on 54 COPD patients, 45 males and 9 females, aged 69 ± 10 （Group A）, 8 COPD patients who failed to receive the routine pulmonary function tests （Group B）, and 10 normal controls. The subjects in 3 groups, matched in age, height, body weight, and educational level, underwent 5-point EFL scoring, Medical Research Council （MRC） dyspnea scoring, 6-min walk distance scoring, and routine pulmonary ventilation function test. Results EFL was detected in 41 of the 54 COPD patients in Group A. NEP test was successfully performed on the 8 patients of Group B, and 7 of them were found as with EFL. The level of forced expired volume in one second percentage （ FEV1% ） of the patients with the EFL scores of 2 , 3, and 4 were 55.71% ± 11.77%, 41.21% ± 13.69%, and 29. 84% ± 11.65% respectively, all significantly lower that of the 0-score group （ 83.76% ± 16. 44%, all P 〈 0. 05 ）. Multiple stepwise regression analysis showed that only 5-point EFL score, FEV1% , and 6-rain walking distance were associated with MRC dyspnea score, and the 5-point EFL score showed the best associativity with dyspnea. Condusion As compared with FEV1 pred%, 5-point EFL scoring is more rehable in evaluating the dyspnea of COPD patients, it is simple and doesn＇t＇t require any cooperation on the part of the patients. NEP technique can be applied in the COPD patients who fail to receive the routine pulmonary function testa

关 键 词：肺疾病 阻塞性 呼吸困难 用力呼气流速 

分 类 号：R563.9[医药卫生—呼吸系统]