脉冲振荡法在慢性阻塞性肺疾病中的应用评价  

Evaluation of Respiratory Impedance by Impulse Oscillometry in Patients with Chronic Obstructive Pulmonary Disease

作　　者：谭明旗[1] 王婷[1] 郑海明[1] 

机构地区：[1]中国医科大学附属盛京医院第二呼吸内科,辽宁省沈阳市110021

出　　处：《中国全科医学》2010年第7期732-734,共3页Chinese General Practice

摘　　要：目的探讨脉冲振荡法(IOS)测定在慢性阻塞性肺疾病(COPD)中的应用价值。方法选择76例COPD患者(COPD组)和20例健康者(对照组),比较两组常规肺功能检查结果与IOS测定结果。结果COPD组用力肺活量(FVC)、一秒钟用力呼气容积(FEV1)、一秒钟用力呼气容积占用力肺活量比值(FEV1/FVC%)、一秒钟用力呼气容积实测值/预计值(FEV1/pre%)检测结果均低于对照组,差异有统计学意义(P<0.05),COPD组呼吸总阻抗(Zrs)、总气道阻力(R5)、周边黏性阻力(R5-R20)、共振频率(Fres)、周边阻力(Rp)均高于对照组,差异有统计学意义(P<0.05),且与肺通气功能呈负相关(P<0.05);周边弹性阻力(X5)明显低于对照组,差异有统计学意义(P<0.05),与肺通气功能呈正相关(P<0.05);其中Fres的相关性最为密切(P<0.01),Fres、Zrs、X5诊断COPD具有较高的敏感度(分别为96.8%、85.2%、66.1%)和特异度(分别为70.7%、77.3%、85.3%)。结论IOS肺功能测定可用于COPD的诊断,与常规肺通气功能检查在COPD的诊断中具有良好的相关性及互补性;Fres为诊断COPD气流受限最敏感的指标。Objective To explore the clinical application value of impulse oscillometry （IOS） in patients with chronic obstructive pulmonary disease （COPD）.Methods To compare the parameters of pulmonary ventilation function with the results of respiratory impedance measured by impulse oscillometry in 76 patients with COPD （COPD group） and 20 healthy adults （Control group）.Results There was a significant decrease in FVC,FEV1,FEV1/FVC%,and FEV1/pre% in the COPD group compared with control group （P〈0.05）.Respiratory impedance （Zrs）,respiratory resistance at 5Hz （R5）,R5-R20,resonant frequency （Fres）,and peripheral resistance （Rp） in the COPD group were significantly higher than those in the control group （P〈0.05）,and negatively correlated with the pulmonary ventilation function （P〈0.05）.Reactance at 5Hz （X5） in the COPD group was significantly lower than that in the control group （P〈0.05）,and passively correlated with the pulmonary ventilation function （P〈0.05）.Of all indexes,the closest correlation was Fres （P〈0.01）.The sensitivities of Fres,Zrs and X5 in diagnosing COPD were 96.8%,85.2% and 66.1% respectively,and the specificities were 70.7%、77.3% and 85.3% respectively.Conclusion The impedance measured by impulse oscillometry is suitable for the diagnosis of COPD.It is of good correlation and complementarities with conventional pulmonary ventilation function in diagnosis of COPD.Fres is the most sensitive index in the parameters of impulse oscillometry to confirm the presence of airflow limitation in COPD patients.

关 键 词：肺疾病 慢性阻塞性 脉冲振荡法 肺功能测定 

分 类 号：R563[医药卫生—呼吸系统]