脉冲振荡法对不同临床亚型慢性阻塞性肺疾病患者呼吸阻抗的评估价值  

Assessment Value of Impulse Oscillometry on Respiratory Impedance of COPD Patients with Different Clinical Subtypes

作　　者：李朋[1] 侯刚[1] 王秋月[1] 康健[1] 

机构地区：[1]中国医科大学附属第一医院呼吸疾病研究所,辽宁省沈阳市110001

出　　处：《实用心脑肺血管病杂志》2015年第2期34-37,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家十二五科技支撑计划课题(2012BAI05B00);辽宁省科技厅课题(2013225049);辽宁省科技厅优秀人才计划(2014021031)

摘　　要：目的探讨脉冲振荡法(IOS)对不同临床亚型慢性阻塞性肺疾病(COPD)患者呼吸阻抗的评估价值。方法收集2013年5月—2014年5月在中国医科大学附属第一医院呼吸科门诊随诊的稳定期COPD患者66例,均进行IOS检测、常规肺功能检测及高分辨率CT(HRCT)检查。比较不同临床亚型COPD患者IOS检测指标、常规肺功能检测指标,并分析两者间的相关性。结果 66例患者中,肺气肿型COPD患者23例(观察组),慢性支气管炎型COPD患者43例(对照组),两组患者性别、年龄、肺功能分级、吸入支气管扩张剂后一秒率(FEV1/FVC)、残气量(RV)/肺总量(TLC)、深吸气量(IC)/TLC、共振频率(Fres)、总气道阻力(R5)、中心气道阻力(R20)比较,差异均无统计学意义(P>0.05);观察组患者第一秒用力呼气容积(FEV1)占预计值百分比(FEV1%Pred)、5Hz时电抗(X5)低于对照组,周边气道阻力(R5-R20)高于对照组(P<0.05)。Pearson相关分析结果显示,X5与FEV1%Pred、IC/TLC呈正相关,与RV/TLC呈负相关;R5与RV/TLC呈正相关,与IC/TLC呈负相关;R5-R20与FEV1%Pred、IC/TLC呈负相关,与RV/TLC呈正相关(P<0.05)。结论不同临床亚型COPD患者IOS检测指标存在一定差异,IOS检测有助于更好地评估不同临床亚型COPD患者呼吸阻抗。Objective To investigate the assessment value of impulse oscillometry（ IOS） on respiratory impedance of COPD patients with different clinical subtypes. Methods From May 2013 to May 2014,a total of 66 stable COPD patients were selected in Department of Respiratory Outpatient,the First Affiliated Hospital of China Medical University,all of them received IOS examination,routine lung function testing and HRCT examination. IOS index and routine lung function testing index were compared between patients with different clinical subtypes,and their correlation was analyzed. Results In the 66 patients,23 cases were emphysema type（ observation group）,43 cases were chronic bronchitis type（ control group）. No statistically significant differences of gender, age, lung function grading, FEV1/ FVC, RV / TLC, IC / TLC, Fres, R5, R20 was found between the two groups（ P〈0. 05）; FEV1% Pred,X5 of observation group were lower than those of control group,while R5-R20 of observation group was higher than that of control group（ P〈0. 05）. Pearson correlation analysis showed that,X5 was positively correlated with FEV1% Pred,IC / TLC,respectively,was negatively with RV / TLC（ P〈0. 05）; R5 was positively correlated with RV / TLC,was negatively with IC / TLC（ P〈0. 05）; R5-R20 was negatively correlated with FEV1% Pred,IC /TLC,respectively,was positively with RV / TLC（ P〈0. 05）. Conclusion IOS index is different in COPD patients with different clinical subtypes,IOS examination is helpful to preferably assess the respiratory impedance.

关 键 词：肺疾病 慢性阻塞性 呼吸功能试验 肺气肿 脉冲振荡法 

分 类 号：R563.05[医药卫生—呼吸系统]