肺容量和弥散功能在不同级别慢性阻塞性肺疾病患者中的表现  

Lung Capacity and Diffusing Capacity in Patients with Chronic Obstructive Pulmonary Disease at Different Stages

作　　者：李林蔚[1] 杜晶[1] 邓燕[1] 祖萍[1] 何太灵[1] 袁玉茹[1] 梁斌苗[1] 

机构地区：[1]四川大学华西医院呼吸与危重症医学科,四川成都610041

出　　处：《中国呼吸与危重监护杂志》2015年第5期436-438,共3页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：四川省科技厅支撑计划(编号:2014SZ0010)

摘　　要：目的探讨不同级别慢性阻塞性肺疾病(简称慢阻肺)患者肺容量和弥散功能的特点及临床意义。方法收集2014年1月至2015年3月就诊于四川大学华西医院呼吸与危重症医学科门诊的慢阻肺患者,记录其临床资料、肺通气功能指标[第1秒用力呼气容积(FEV1)]以及肺容量指标[肺总量(TLC)、残气容积(RV)及RV/TLC],采用体积描记法和气体稀释法进行测定,并采用单次呼吸法测定肺一氧化碳弥散量(DLCO)。将患者分为轻度、中度、重度和极重度组,对组间资料进行比较,并对肺通气功能指标与肺容量和DLCO%pred的相关性进行分析。结果共计170例慢阻肺患者被纳入研究。随慢阻肺程度的加重,肺容量指标(TLC、RV和RV/TLC)逐渐增加,而且体积描记法和气体稀释法两种方法之间的差值ΔTLC%pred、ΔRV%pred和ΔRV/TLC逐渐增加。随FEV1%pred的降低,DLCO%pred则逐渐降低。相关分析显示,FEV1%pred与ΔTLC%pred、ΔRV%pred和ΔRV/TLC呈显著负相关,与DLCO%pred呈显著正相关。结论与气体稀释法相比,体积描记法能更准确地对慢阻肺患者的肺容量进行测定。随气流受限程度加重,慢阻肺患者弥散功能逐渐下降。Objective To assess the lung capacity and diffusing capacity in patients with chronic obstructive pulmonary disease（ COPD） at different stages.Methods Patients who were diagnosed with COPD between January and March 2015 were recruited in the study.The data of clinical characteristics and spirometry test（ the forced expiratory volume in the first second,FEV1） were collected.Total lung capacity（ TLC） and residual volume（ RV） were determined by body plethysmography and helium dilution method,and single breath diffusing capacity for carbon monoxide（ DLCO） was also measured.Lung capacity and the deviations between two methods,and DLCO% pred were compared among the COPD patients at different stages.The correlation of spirometry with lung capacity and DLCO% pred were analyzed.Results A total of170 patients with COPD were enrolled.With the severity of COPD,TLC% pred,RV% pred,RV / TLC and the deviations of the ones between two methods increased significantly,but DLCO% pred reduced significantly.FEV1% pred were negatively correlated with the deviations of lung capacity between two methods,and positively correlated with DLCO% pred.Conclusions Compared with helium dilution method,the body plethysmography is more accurate for evaluating the lung capacity of COPD.With the severity of airflow limitation,the diffusing capacity of COPD decreases gradually.

关 键 词：慢阻肺 肺容量 肺一氧化碳弥散量 

分 类 号：R563.9[医药卫生—呼吸系统]