慢性阻塞性肺疾病患者中枢呼吸驱动和气道阻力的研究  

Evaluation and relationship of central respiratory drive and respiratory resistance in the patients with COPD

作　　者：冯 靖[1] 朱宝玉[1] 陈光瑾[1] 陈学颖[1] 李 荛[1] 

机构地区：[1]天津医科大学总医院呼吸科,300052

出　　处：《实用心脑肺血管病杂志》2002年第2期76-80,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的 探讨在①上呼吸道感染所致急性咳嗽组（无阻塞组）;②慢性阻塞性肺疾病所致气道轻度阻塞组;③慢性阻塞性肺疾病所致气道中度阻塞组;④慢性阻塞性肺疾病所致气道重度阻塞组患者的中枢呼吸驱动（P0.1）、最大通气时的中枢呼吸驱动（P0.1MAX）、最大口腔吸气压（PI　MAX）、最大口腔呼气压（PE　MAX）、中枢呼吸驱动储备（P0.1/P0.1MAX）、有效吸气阻抗（P0.1/Vt/Ti）以及4Hz振荡频率下呼吸阻力（Rfo4Hz）、4Hz振荡频率下吸气末阻力（Rin4Hz）、4Hz振荡频率下呼气末阻力（Rex4Hz）的水平:以及上述呼吸驱动指标与4Hz振荡频率下呼吸阻力诸指标之间的关系。方法 本研究共包括216例男性患者,其年龄在35岁～60岁之间,分为以下各组:①上呼吸道感染所致急性咳嗽组;②慢性阻塞性肺疾病所致气道轻度阻塞组:③慢性阻塞性肺疾病所致气道中度阻塞组;④慢性阻塞性肺疾病所致气道重度阻塞组。以上呼吸道感染所致急性咳嗽组为对照组,目的在于尽量排除咳嗽对中枢呼吸驱动的影响。比较采用单因素方差分析,组间两两比较采用SNK-q检验,两因素之间的相关性分析采用直线相关分析。结果PIMAX、PEMAX在各个组之间无显著性差异,P0.1、P0.1MAX、P0.1/P0.1MAX、P0.1/Vt/Ti以及呼吸阻力诸指标均发生了不同程度的改变;ve To evaluate central respiratory drive(P0.1)[kPa], central respiratory drive in MVV(maximal voluntary ventilation)(P0.1 MAX) [kPa], Maximum inspiratory pressure (PI MAX) [kPa] , Maximum expiratory pressure(PE MAX) [kPa], reservation of central respiratory drive (RCRD) (measured by P0.1/P0.1 Max[MVV-P0.1, maximal voluntary ventilation-P0.1 ]), effective inspiratory resistance(P0.1/Vt/Ti) [kPa·min/l] , resistance of airway ( RAW) (measured by forced oscillation technology- FOT with 4 Hz air waves (Rfo) , resistance of airway( RAW) in the end of inhalation and exhalation( measured by forced oscillation technology-FOT with 4Hz air waves [Rin and Rex]) , and the relationship between parameters of respiratory drive and parameters of resistance of airway in patients who had airway obstruction, owing to COPD. Methods There were 216 patients whose age between 35 and 60 in this research. They were divided into four groups: ①upper respiratory tract infection with cough (URIC) ;②COPD with slight airway obstruction. ③COPD with middle airway obstruction;④COPD with severe airway obstruction. The URIC group was taken for the control group and the purpose was to reduce the effect of cough on central respiratory drive. Analysis of variance was used for evaluation. The comparison between each two groups was measured by SNK-q test and the relationship between parameters of respiratory drive and RAW was measured by linear correlation analysis. Results There were significant differences between the groups in P0.1 ,P0.1 MAX, RCRD, P0.1/Vt/Ti and RAW,but not in PI MAX and PE MAX; P0.1, P0.1/P0.1 MAX, P0.1 /Vt/Ti were related with RAW significantly. Conclusion COPD patients were higher in the levels of centralpespiratory drive, effective inspiratory resistance and lower in the levels of reservation of central respiratory drive, so COPD patients were more sensitive to infections, heart failures and some other emergencies and more vulnerable .o respiratory failure. If the resistance of airway of COPD patients are ameliorated, th

关 键 词：慢性阻塞性肺疾病 中枢呼吸驱动 气道阻力 研究 

分 类 号：R541.5[医药卫生—心血管疾病]