脉冲振荡法测定正常和急性肺损伤前后犬呼吸力学  

Respiratory Mechanics of Normal and Acute Lung Injury Dogs Measured by Impulse Oscillometry

作　　者：王美琴[1] 钮善福[2] 方智野[2] 李燕芹[2] 朱蕾[2] 白春学[2] 

机构地区：[1]上海医科大学华山医院内科,上海200040 [2]上海医科大学中山医院呼吸病研究所,上海200032

出　　处：《上海医科大学学报》1999年第6期436-438,共3页Journal of Fudan University(Medical Science)

摘　　要：目的　探讨肺水肿对呼吸力学的影响。方法　用脉冲振荡法测定急性肺损伤 (ALI)犬 5～ 3 5Hz呼吸阻抗。结果　注射油酸前 ,呼吸系粘性阻力随着频率增大有轻微降低 ,电抗随着频率增大有轻微升高。共振频率为( 5 .0 7± 0 .65 )Hz。注射油酸后 5～ 2 5Hz呼吸阻力 (R5～R2 5)明显增大 ,3 5Hz呼吸阻力 (R35)无明显增大。 5Hz电抗 (X5)明显降低 ,周边弹性阻力增大约 4倍。但 10～ 3 5Hz电抗无明显改变。共振频率增加到 ( 7.74± 2 .4 1)Hz。而且R5与PaO2 /FiO2 呈高度负相关 ,X5与PaO2 /FiO2 呈高度正相关。结论　进一步证实ALI存在呼吸动力功能异常。认为R5≥ 1.0kPa/ (L·s)及X5≤ - 0 .2 5kPa/ (L·s)作为辅助诊断ALI的指标较为合适 ,R5和X5可作为评价ALI严重程度检测的可靠指标值得临床使用。Purpose To study the effect of pulmonary edema on respiratory system mechanical properties with impulse oscillometry. Methods The impedance of the respiratory system was measured at the range from 5 to 35 Hz with impulse oscillometry in six dogs before and after pulmonary edema from acute lung injuy produced by injection of oleic acid. Results Before oleic acid injection,as frequence increased, the respiratory system of viscous resistances decreased slightly and reactance increased slightly.Resonance frequence was (5.07±0.65)Hz.After oleic acid injection,the respiratory resistances at 5～25 Hz, R 5～R 25 increased markedly, the respiratory resistances at 35Hz.R 35 didn't increased markedly;reactance at 5Hz,X 5 decreased significantly.The peripheral elastic resistance increased about 4 times.There were no significant changes for reactance at 10～35 Hz.Resonance frequence increased to (7.74±2.41)Hz.Moreover,R 5 was highly negatively correlate with PaO 2/FiO 2 and X 5 was highly positively correlate with PaO 2/FiO 2. Results Before oleic acid injection,as frequence increased, the respiratory system of viscous resistances decreased slightly and reactance increased slightly.Resonance frequence was (5.07±0.65)Hz.After oleic acid injection,the respiratory resistances at 5～25 Hz, R 5～R 25 increased markedly, the respiratory resistances at 35Hz.R 35 didn't increased markedly;reactance at 5Hz,X 5 decreased significantly.The peripheral elastic resistance increased about 4 times.There were no significant changes for reactance at 10～35 Hz.Resonance frequence increased to (7.74±2.41)Hz.Moreover,R 5 was highly negatively correlate with PaO 2/FiO 2 and X 5 was highly positively correlate with PaO 2/FiO 2. Conclusions The present study has further proved that there is respiratory dynamic function abnormality in acute lung injury(ALI).We think R 5≥1.0 kPa/(Ls) and X 5≤-0.25 kPa/(Ls) are the proper indices in ALI assistant diagnosis .R 5 and X 5 can be used as

关 键 词：急性 肺损伤 脉冲振荡法 呼吸力学 肺水肿 

分 类 号：R541.630.4[医药卫生—心血管疾病]