对比呼气负压与传统方法检测慢性阻塞性肺疾病患者呼气气流受限  

To compare negative expiratory pressure technique with conventional tests in detecting expiratory flow limitation in chronic obstructive pulmonary diseases patients

作　　者：陈瑞[1,2] 陈荣昌 刘杰[1] 岑燕遗[1] 陈炼[3] 

机构地区：[1]广州医学院第一附属医院呼吸疾病国家重点实验室,510120 [2]中山大学附属第二医院呼吸内科,广州510120 [3]广东省人民医院门诊部

出　　处：《中华内科杂志》2010年第2期122-124,共3页Chinese Journal of Internal Medicine

摘　　要：目的对比呼气负压（NEP）与传统方法检测慢性阻塞性肺疾病（COPD）患者呼气气流受限（EFL）。方法应用NEP与传统方法（层流型流量计）检测72例COPD缓解期患者EFL；对20例不能完成传统测试的患者应用NEP检测其EFL；对比两种方法的检测结果。结果72例COPD患者应用NEP54例（75％）检测到EFL。第1秒用力呼气容积（FEV。）占预计值百分比EFL评分2分者为（46．92±12．7,1）％，3分者为（33．35±8．96）％，显著低于EFL评分1分者[（63．60±16．65）％1。ROC曲线分析NEP曲线下面积（AUC）为0．903，层流型流量计AUC为0．761。20例不能完成传统测试的患者均能耐受NEP测试，19例检测到EFL。结论应用NEP检测COPD患者EFL，比应用传统方法检测更能准确反映COPD患者呼吸困难的严重程度；NEP操作简单、无需患者主动配合，可在不能完成传统测试的患者中应用。Objective To compare negative expiratory pressure （NEP）technique with conventional test in detecting expiratory flow limitation （EFL）in chronic obstructive pulmonary diseases（COPD） patients. Methods EFL was measured with NEP technique and conventional method respectively in 72 COPD patients;EFL was measured with NEP technique in 20 COPD patients who failed to perform conventional test. Results EFL was detected in 54 of the 72 COPD patients. NEP test was successfully performed on the 20 patients, and 19 of them were found with EFL. The level of forced expired volume in one second percentage（FEV1% ）of the patients with 2-score group （46.92 ± 12. 74）% and 3-score group（33. 35 ± 8.96） % were significantly lower than that of the 1-score group （63.60 ± 16.65 ）%. Area under curve of NEP technique and conventional test in ROC is 0. 903 and 0. 761 respectively. Conclusions As compared with conventional test, EFL detected with NEP technique is more reliable in evaluating dyspnea of COPD patients. It is simple and doesn＇t require any cooperation of the patients. NEP technique can be applied in COPD patients who fail to receive conventional test.

关 键 词：肺疾病 慢性阻塞性 呼吸困难 呼气流速受限 

分 类 号：R563.9[医药卫生—呼吸系统]